Correlative Study On The Efficacy Of PLIF In The Treatment Of Elderly Degenerative Lumbar Spinal Stenosis After Operation Based On Constitution Classification Of TCM

Objective:This paper aims to analyze the difference of curative effect after operation(PLIF)for senile degenerative lumbar spinal stenosis with different physique types,and to explore the common etiology,pathogenesis and correlation with postoperative curative effect of senile degenerative lumbar spinal stenosis based on TCM physique theory.Methods:According to the criteria of physique identification,a total of 80 patients in three types of patients were selected as subjects:general physique,Yang deficiency physique and blood stasis physique.Data of general condition,perioperative related indexes,preoperative and postoperative VAS score,JOA score,quality of life score and 12-month postoperative X-ray(Lumbar spine positive and lateral)to observe vertebral fusion were collected in three groups of patients,and analyzed by SPSS 22.0 statistical software.Results:Patients’ sex and age composition were compared,the difference was not statistically significant(P>0.05),the three groups of patients were comparable:There was no difference in operation time,intraoperative blood loss and postoperative drainage volume among the three groups(P>0.05),but the postoperative hospital stay in the General physique group was significantly shorter than that in the Yang deficiency group and the blood stasis group(P<0.05);The perioperative complication rate of the patients was 4.7%,and there was no significant difference between the three groups(P>0.05);The VAS score and JOA score in the three groups of patients were significantly improved compared with those before surgery(P<0.01),there were no differences between the three groups of VAS scores and JOA scores before operation,1 month after operation and 3 months after operation.6 months after operation,the comparison between the groups,general physique group and Yang deficiency group compared with blood stasis group VAS score was lower,postoperative pain improvement was more significant(P<0.05),general physique group and blood stasis group Compared with the Yang deficiency group,the JOA score was higher and the lumbar spine function recovery was more significant(P<0.05);The scores of all dimensions of the SF-36 quality of life scale in the three groups of patients were significantly improved compared with those before the operation(P<0.01).There was no difference between the three groups in the four dimensions of role-physical,bodily pain,social function and role-emotional(P>0.05).In the four dimensions of physical function,general health,vitality and mental health,the scores of the general physique group were higher than those of the Yang deficiency group(P<0.05),The scores in the two aspects of general health and mental health showed the performance of general physique group>blood stasis group>Yang deficiency group(P<0.05);PLIF shows excellent bone graft fusion effect on patients with different constitutions,there was no difference between the three groups(P>0.05).Conclusions:PLIF technology significantly improves the quality of life of elderly DLSS,the treatment effect is obvious,and the effectiveness and safety are high;General physique has obvious advantages over yang deficiency physique and blood stasis physique in postoperative curative effect and recovery.The analysis of the patient’ s physique is biased,which has certain reference value for guiding the syndrome differentiation and clinical individualized treatment of the disease.