| Objective:Through the analysis of percutaneous transforaminal endoscopic decompression(PTED) treatment of degenerative lumbar spinal stenosis(DLSS) before and after surgery in improving clinical symptoms and imaging changes of relevance, clears and defines the responsibility section for clinical surgery and provides the basic theory for adequate decompression, further promote the technology of PTED specifications used in the treatment of DLSS.Methods:Randomly selected the first diagnosed with DLSS in hospitalized patients and meet the inclusion criteria and exclusion criteria. Preoperative evaluation of patients with back and leg pain VAS score, ODI index, claudication distance, improve the preoperative related parallel CT, MRI, CT measurement of the central canal of related parameters(including bony vertebral canal largest sagittal diameter line, cross sectional area, the maximum horizontal diameter line, around the central canal area of three partitions and bilateral lateral crypt lines and before and after bilateral sagittal area and intervertebral foramen maximum and minimum sagittal diameter line);Then, measurement of magnetic resonance imaging(MRI) in the dural sac associated parameters(including cross sectional area, the largest sagittal diameter line, the maximum horizontal diameter line,the area of the dural sac three partitions). Analysis the related parameters and combining with clinical symptoms to determine liability section, clear surgical decompression, and make operation plan; Operation process strictly according to the preoperative determinethe responsibility of the segment and decompression site to locate and implementation of the operation. Assessed 3, 6 months again after surgery with back and leg pain VAS score,ODI index, walking distance, surveying the parameter of CT, MRI, we review the corresponding of parameters. Contrast before and after surgery in patients with clinical symptoms improve the situation as well as the improvement of imaging parameters before and after surgery, the SPSS22.0 software is adopted to measured imaging data before and after operation and the patients’ age, gender, claudication distance and other related data by Spearman correlation analysis; Imaging parameters and clinical symptoms(VAS and ODI) using Pearson correlation analysis and multivariate linear regression analysis for statistical analysis.Results:Participate in this study, a total of 92 cases of patients, including 49 patients with male, accounted for 53.26%, 43 patients with women, accounting for 46.74%, the average age of 56.22 years old. Postoperative clinical curative effect is on the basis of Mac Nab score: 40.22%(37 cases), 54.35%(50 cases), 3.26%(3 cases), 2.17%(2 cases),general surgery was 94.57%. Imaging data within the group and between groups variance analysis showed that each group overall have obvious difference(P < 0.04). Imaging parameters and related data, such as the patients age, sex, adopts Spearman correlation analysis results show that no significant correlation(P > 0.05). The improvement of clinical symptoms and the central canal cross sectional area, left and right sides is the largest diameter line, the central spinal canal left, middle and right three partitions, dural sac cross-sectional area and the area of the three partitions etc. Have strong correlation(P< 0.01); With the central vertebral canal sagittal diameter line, the largest dural sac maximum sagittal diameter line, lateral crypt lines before and after, intervertebral foramen area has a certain correlation(P < 0.05).Conclusion:For the implementation of percutaneous transforaminal endoscopic decompression technique in the treatment of degenerative lumbar spinal stenosis disease surgery,preoperative should carefully assess clinical symptoms, and detailed analysis of the imaging changes, clear responsibilities according to the patient’s symptoms, signs and imaging data segment and decompression site can effectively improve the clinical curative effect and purpose of the operation. |
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