Case-control study on the treatment of single-segment lumbar spinal stenosis with modified interlaminar approach and traditional approach


Objective:

To explore the clinical effect of modified interlaminar approach for the treatment of single-segment lumbar spinal stenosis.


Methods:

From February 2015 to August 2017, 80 patients with single-segment lumbar spinal stenosis planned to undergo endoscopic surgery were selected, including 38 males and 42 females;aged 33 to 69 (47.6±9.5) years old. Using random number table method, the patients were divided into study group and traditional group, 40 cases in each group, and underwent surgical treatment through modified translaminar approach and traditional approach respectively. The operation time, intraoperative blood loss, and hospital stay were recorded;visual analogue scale (VAS) and Oswestry Disability Index (ODI) before and after operation were compared between two groups;spinal canal arca, spinal canal diameter, disc yellow space and surgical complications were observed.


Results:

All 80 patients were followed up for at least 3 months. Two patients had incision infection, both of them were in traditional group;there was no significant difference in operation time between two groups(P>0.05). Intraoperative blood loss and hospital stay in study group were lower than those in traditional group(P<0.05). At 1 week and 3 months after operation, VAS and ODI of all patients were significantly lower than before operation (P<0.05), but the difference between two groups was not statistically significant (P>0.05). At 3 months after surgery, measured values of spinal canal area and spinal canal diameter were larger in study group than in traditional group (P<0.05). The operative complication rate of the study group was 5.00% compared with 12.50% of the traditional group, and the difference was not statistically significant (P>0.05).


Conclusion:

Compared with the traditional approach, the modified interlaminar approach has advantages of less trauma, faster recovery and better postoperative spinal space recovery in the treatment of single-segment lumbar spinal stenosis.


Keywords:

Case-control studies; Endoscopes; Spinal stenosis; Surgical approach.

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