Clinical Efficacy Comparison Of Bilateral Decompression Via Unilateral Approach By Minimally Invasive Channel Surgery Under The Microscope And Traditional Surgery In The Treatment Of Lumbar Spinal Stenosis

Objective To investigate the clinical efficacy and advantages and disadvantages of bilateral decompression via unilateral approach by minimally invasive channel surgery under the microscope and traditional posterior open surgery in the treatment of lumbar spinal stenosis.Methods A retrospective analysis of patients with lumbar spinal stenosis was carried out which were treated by either minimally invasive surgery under the microscope assisted of20 cases(minimally invasive group)and the traditional lumbar posterior decompression of 21 cases(traditional group)from August 2015 to March 2017.To compare the operate time,intraoperative blood loss,complication,pre-operation and post-operation visual analogue scale(VAS)、 Oswestry Dysfunction Index(ODI)score and data of imaging to evaluate the therapeutic effect of the two groups.Results1 case of traditional surgery and 2 cases of minimally invasive surgery in the dural laceration were complicated with dural sac rupture and afforded to brain cotton piece,gelatin sponge,pressure bandaging and antibiotics to prevent infection.All patients?wounds were healing well and there were no complications after surgery.All patients were followed up for at least six months after surgery.There was no significant differene between the two groups in routine data,lumbago 、 skelalgia(visual analogue scale,VAS)VAS score,lumbar vertebrae(Oswestry disability index,ODI)ODI score,(P >0.05).The minimally invasive group’s time of operation and intraoperative fluoroscopy time were significantly higher than those of the traditional group(P <0.05).The number of bleeding and postoperative drainage in the traditional group were significantly higher than those in the minimally invasive group(No drainage tube was placed in minimally invasive group after postoperative,P <0.05);The mean postoperative hospital stay in the minimally invasive group was less than that in the traditional group(P <0.05).Compared with before,the lumbago and skelalgia VAS score and Oswestry disability index(ODI)score were decreased in post-operation in both groups(P <0.05).The skelalgia VAS and ODI score of the two groups was not statistically significant in post-operation(P> 0.05),but the minimally invasive group lumbago VAS score was lower than that of open group in post-operation(P <0.05).Satisfactory rate in the minimally invasive group was excellent in 11 cases,good in 6cases,fair in 3 cases and no poor,with the excellent and good rate of 85%.While in the traditional group there was excellent in 13 cases,good in 5 cases,fair in 3 cases and no poor with the excellent and good rate of 85.7%.There were no significant differences in the excellent and good rate between the two groups(P> 0.05).Conclusion To compare with the traditional surgery decompression,minimally invasive channel under microscope assisted decompression treatment of single segment lumbar spinal stenosis can get a good clinical effect and had advantages of minimal incision,less blood loss,less complications,no postoperative drainage,less recovery time,making it worth popularizing in clinic.