Efficacy Analysis Of PE-ULBD In The Treatment Of Lumbar Spinal Stenosis

Objective(s):Objective to compare the clinical effects of percutaneous endoscopic unilateral laminectomy for bilateral decompression(PE-ULBD)and microendoscopic unilateral laminectomy for bilateral decompression(MED-ULBD)in the treatment of lumbar spinal stenosis,Objective to investigate the clinical effect of PE-ULBD in the treatment of lumbar spinal stenosis.Methods:40 patients with single segment degenerative lumbar spinal stenosis scheduled for surgery in our department from January 2019 to January 2020 were selected as the research objects.The patients were randomly divided into PE-ULBD group and MED-ULBD group.Before the operation,X-ray films of lumbar vertebrae in anteroposterior and lateral position,hyperextension and hyperflexion position,CT and MRI of lumbar vertebrae were performed routinely.The diagnosis and exclusion of contraindications were confirmed to confirm whether the case met the criteria of this study.There were no significant differences in gender,age,preoperative ODI score and VAS score of lumbocrural pain between the two groups.PE-ULBD and MED-ULBD were performed by the same experienced surgeon in our hospital.Both groups were operated in prone position under general anesthesia.Observation indexes:(1)the operation time,intraoperative blood loss,incision length,hospital stay and complications of the two groups were observed(2)VAS scores of low back and lower limbs were followed up before operation,1 day after operation,3 months after operation and 6 months after operation.ODI scores were collected before operation and 6 months after operation to comprehensively evaluate the functional improvement of patients(3)CT was reexamined on the first day after operation,and the increased cross-sectional area of dural sac was measured before operation.Results:All patients completed the operation successfully.In MED-ULBD group,there was one case of dural sac tear,which was treated with bed rest,rehydration,anti infection and other symptomatic treatment,and recovered well without other adverse symptoms.The VAS score and ODI score of the two groups were significantly lower than those before operation,and the cross-sectional area of the narrowest lesion segment was significantly increased before and after CT imaging,but there was no statistical difference between the two groups,indicating that the two methods can effectively treat lumbar spinal stenosis,and there was no significant difference in clinical efficacy.However,the blood loss,length of hospital stay and improvement of low back pain on the first day after operation in PE-ULBD group were better than those in MED-ULBD group(P<0.05),which proved that PE-ULBD had less trauma and shorter recovery time than MED-ULBD group.Conclusion(s):This study shows that both PE-ULBD and MED-ULBD are effective clinical methods for the treatment of single segment simple degenerative lumbar spinal stenosis.However,when PE-ULBD achieves the same therapeutic effect as MED-ULBD,its visual field is clearer,trauma is smaller,and it is more conducive to patients,so it should be widely promoted.