Early Clinical Efficacy Of Unilateral Laminotomy For Bilateral Decompression Through Interlaminar Approach With Spinal Endoscopy And Modified TLIF In The Treatment Of Lumbar Spinal Stenosis

Objective: To treat lumbar spinal stenosis with bilateral decompression via a unilateral interlaminar approach under spinal endoscopy and the traditional posterior modified TLIF technique to compare the early clinical treatment effects of the two groups of operations for the clinical treatment of lumbar spinal stenosis Lay the foundation.Methods: A retrospective study method was used to collect 41 patients with single-segment lumbar spinal stenosis included in the Department of Orthopedics,Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from July 2019 to July 2020.Patients in the observation group used spinal endoscopy.Bilateral decompression via unilateral interlaminar approach,the number of patients in this group was 19;the control group patients used the classic TLIF surgical treatment,the number of patients in this group was 22.Research and analyze the basic information of age,gender,operation segment and disease course of the second group.The VAS score and ODI score of low back and leg pain before and after surgery were obtained,and the effect of treatment by modified Mac Nab was evaluated.The data obtained was analyzed and the early treatment effect of the above two treatment methods was compared.Results: The two groups of patients were followed up for 1 year after the operation.The basic data before the operation of the two groups were analyzed and compared,such as gender,age,operation segment and disease course,and there was no significant difference(P>0.05).Compared with the control group,there were significant differences in the observation group’s operation time,intraoperative blood loss,number of fluoroscopy,and length of stay in hospital(P<0.05).Compared with before surgery,the VAS scores and ODI scores of low back pain and leg pain in the two groups decreased significantly(P<0.05).At the same time,except for low back pain,the scores at each time point were significantly different.The VAS scores and ODI scores of leg pain were not There is a significant difference(P>0.05).Compared with the control group,the VAS score of low back pain in the observation group was significantly lower(P<0.05).At the last follow-up,the excellent and good rates of the observation group and the control group were 94.7% and 86.7%,respectively,and there was no significant difference(P>0.05).Comparing the postoperative complications of the two groups,it is concluded that the number of patients in the observation group with intraoperative dural sac tear and transient sensory disturbance is one case,and the control group has one patient with postoperative infection,who recovered after corresponding symptomatic treatment normal.Conclusion: Observing the early treatment effect of lumbar spinal stenosis,it is concluded that both the bilateral decompression through the interlaminar approach and the modified TLIF operation under spinal endoscopy can obtain good treatment results.At the same time,there are many advantages in bilateral decompression via a unilateral interlaminar approach under spinal endoscopy.This method uses minimally invasive technology,has significant therapeutic effects,and is safe in operation,and is worthy of being popularized.