Effect Of Intervertebral Vacuum On The Efficacy Of Posterior Lumbar Interbody Fusion For Degenerative Lumbar Disc Disease

Objective To analyze and investigate the effect of intervertebral vacuum on the efficacy and fusion rate of posterior lumbar fusion after degenerative lumbar disc disease.Methods A retrospective study of patients with degenerative lumbar disc disease(single-segment)who underwent lumbar posterior lumbar fusion surgery at Yinchuan Guolong Hospital from September 2015 to October 2018.57 patients were screened according to inclusion and exclusion criteria.According to the presence or absence of intervertebral vacuum,27 patients in the vacuum group(9 males and 18 females)with an average age of 61.11±9.50 years.There were 2 cases of L3-L4,16 cases of L4-L5,and 9cases of L5-S1.There were 30 patients in the non-vacuum group(11 males and 19 females)with an average age of 57.80±7.99 years.There were 3 cases of L3-L4,17 cases of L4-L5,and 10 cases of L5-S1.Both groups underwent transforaminal Lumbar Interbody Fusion(TLIF).The two groups of basic data were sorted for follow-up.The preoperative and postoperative follow-up VAS scores,Oswestry dysfunction index questionnaire,postoperative complications,postoperative intervertebral fusion and other relevant data were statistically analyzed to investigate the intervertebral vacuum phenomenon.The effect of postoperative TLIF on the efficacy and fusion rate of lumbar disc disease..Results In the 57 patients(vacuum group + non-vacuum group),the lumbar vertebrae were displayed in both groups.The internal fixation was firm and the cage was not displaced.In this study,lumbar reconstruction was performed 1 year after operation.The results of CTexamination showed that no unfused patients were found.In the experimental group,20 patients were completely fused(Class I),3 patients were mostly fusion(Class II),4 patients were partially fused(Class III),and 26 patients in the control group.Fully integrated(level I),4 cases of most of the fusion(level II).There was no significant difference in the rate of intervertebral fusion between the two groups(P>0.05).The level of fusion in the vacuum group was significantly higher than that in the non-vacuum group(P<0.05).The VAS,backache VAS and ODI scores of the patients in the vacuum group were significantly higher than those in the non-vacuum group,and the difference was statistically significant(P<0.05).In the vacuum group,postoperative leg pain,back pain VAS score,ODI score were significantly lower than before surgery,the difference was statistically significant(P < 0.001).In the non-vacuum group,the postoperative leg pain and back pain VAS score and ODI score were significantly lower than those before surgery,and the difference was statistically significant(P<0.001).Conclusion Intervertebral vacuum is one of the factors affecting the rate of intervertebral fusion after posterior lumbar fusion of degenerative lumbar disc disease.it is also one of the influencing factors of aggravation of waist and leg pain.