Effect of paravertebral space approach selective decompression and short-level fusion on postoperative pain and lumbar function in patients with multilevel lumbar spinal stenosis and lumbar instability
Objective:To explore the effect of short-level fusion combined with paraspinal space(Wiltse)approach for selective decompression in the treatment of multilevel lumbar spinal stenosis(LSS)with lumbar instability(LSI).Methods:A total of 174 patients with multilevel LSS and LSI admitted to our hospital from February 2020 to December 2022 were selected and divided into a study group and a control group according to the random number table method(n=87).The study group received short-level fusion combined with the Wiltse approach for selective decompression,while the control group received long-level fusion combined with a posterior median approach for total stenosis decompression.The two groups'surgical indexes,surgical effects,and intervertebral fusion were compared.Japanese Orthopaedic Association(JOA)Score and Visual Analogue Score(VAS)were used before and after surgery to evaluate the lumbar function and pain degree.Stress indexes,such as Renin(R),Lactate dehydrogenase(LDH),Angiotensin Ⅱ(AngⅡ),and Myoglobin(MYO)levels were evaluated by enzyme-linked immunoassay.And complication rates were recorded.Results:Compared with the control group,the postoperative drainage volume and intraoperative blood loss in the study group were less,and the operation time was shorter(P<0.05).Compared with the control group,the JOA score of the study group was higher,and the VAS score of the group was lower(P<0.05).Compared with 88.51%(77/87)in the control group,the rate of excellent and good surgery was 97.70%(85/87)higher in the study group,and 44.81%(95/212)lower in the study group than 100.00%(207/207)in the control group(P<0.05).Compared with the control group,serum levels of R,LDH,AngⅡ,and MYO were lower in the postoperative groups(P<0.05).The total complication rate in the study group was 3.45%(3/87),which is lower than that in the control group(16.09%(14/87))(P<0.05).Conclusions:Short-level fusion combined with the Wiltse approach for selective decompression in the treatment of patients with multi-level LSS and LSI has significant effects,which can optimize surgical indicators,reduce interbody fusion and complications,relieve pain,improve lumbar function,and is minimally invasive.
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