Comparison Of Clinical Efficacy Between PPECD And ACDF For Lumbar Spinal Stenosis

Objective:The clinical effects of percutaneous transforaminal endoscopic decompression(PTED)and posterior lumbar interbody fusion(PLIF)in the treatment of lumbar spinal stenosis were compared.Method : A retrospective analysis of 52 cases of lumbar spinal stenosis patients admitted to our department from June 2016 to June 2019 was performed,of which 34 patients underwent PTED and 18 underwent PLIF.The PTED group is also called the minimally invasive group,and the PLIF group is called the open group,The preoperative data of the two groups were recorded respectively:gender,age,lesion segment,Visual analogue scales(VAS)for lumbar and lower limbs preoperative,preoperative Oswestry Disability Index(ODI),degeneration of adjacent segments preoperative,physiological curvature preoperative,comparison of time between the two groups(surgical time,hospitalization time and bed time),intraoperative situation(bleeding and times of fluoroscopy),postoperative situation(length of incision and incidence of postoperative complications),and waist and lower limb VAS and ODI scores were record,and follow-up time of about 3 years,observe disc degeneration ofadjacent segments in two groups for pfirrmann classification,the lumbar spine X-rays were used to measure the height of the intervertebral space,the range of motion(ROM),and the total lumbar spine motion.Finally,according to the Macnab classification method,the excellent and good rate of the two groups was evaluated.Results:Compared with the PLIF group,the PTED group has the advantages of smaller incisions,less intraoperative blood loss,shorter operation time,shorter hospitalization and bed time,showing significant differences when compared with the PLIF group(P<0.05).the ODI score and waist,lower limb VAS score of the PTED group was better at 1week,1 month,3 month,6 month,1 year and last follow-up than the PLIF group(P<0.05),The incidence of complication was 8.82% in PTED group and was 11.1% in PLIF group,and there was no statistically significant difference between the two group(P>0.05),The height of the intervertebral space in the PTED group decreased compared with preoperative,but the difference was not statistically significant(P>0.05),and the intervertebral mobility and slip angle at the last follow-up were not significantly different from those preoperative(P>0.05).and significantly less than the instability reference value(P<0.05).The ROM of PTED group and PLIF group at last follow-up was not statistically significant compared with preoperative ROM(P>0.05).There was no statistically significant difference between the two groups in the lastfollow-up of the improved lumbar spine Pfrimann classification before surgery(P>0.05).using the Macnab rating method,the overall excellent rate of the PTED group and the PLIF group was 94.1% and 88.9%,respectively.There was no significant statistical difference in the excellent rate between the two groups(P> 0.05).Conclusion:Both the PTED group and the PLIF group can achieve satisfactory clinical efficacy in the treatment of lumbar spinal stenosis.However,the advantages of PTED over PLIF are less trauma,faster recovery,and less impact on segment stability.This technology is worth developing.