Clinical Study of MIS-TLIF in the Treatment of Senile Lumbar Spinal Stenosis by Mast Quadrant Expandable Channel
Objective:To observe the improvement effect of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) on patients with senile lumbar spinal stenosis (LSS) based on Mast Quadrant expandable channel.Method:From January 2022 to January 2023,88 elderly patients with LSS in Ji'an Central People's Hospital were selected to be included in the study,and the patients were divided into control group and observation group with a ratio of 1:1 according to random number table method,with 44 cases in each group.The control group was treated with transforaminal lumbar interbody fusion (TLIF),and the observation group was treated with MIS-TLIF under Mast Quadrant expandable channel.Perioperative indexes and postoperative complication rate were compared between the two groups;pain degree[visual analogue scale (VAS)]and lumbar function[Japanese orthopaedic association evaluation treatment (JOA) and Oswestry disability index (ODI)]were recorded and compared between the two groups before surgery,6 months after surgery,and 12 months after surgery;the oxidative stress indexes[superoxide dismutase (SOD),glutathione peroxidase (GSH-Px) and adrenocorticotropin (ACTH)]of the two groups before and 3 days after surgery were recorded and compared.Result:The operation time,postoperative bed time and hospital stay in the observation group were shorter than those in the control group,the intraoperative blood loss and postoperative drainage volume were shorter than those in the control group,and the surgical incision length was shorter than that in the control group (P<0.05).VAS and ODI scores of the two groups at 6 and 12 months after surgery were significantly lower than those before surgery,the differences were statistically significant (P<0.05),and VAS score and ODI score of the observation group were significantly lower than those of the control group at 6 months after surgery,the differences were statistically significant (P<0.05).At 6 and 12 months after surgery,JOA scores in both groups were significantly higher than those before surgery,the differences were statistically significant (P<0.05);at 6 months after surgery,JOA score in the observation group was significantly higher than that in the control group,the differences were statistically significant (P<0.05).3 dyas after surgery,GSH-Px and SOD in two groups were significantly lower than those before operation,and ACTH levels were significantly higher than those before operation,the differences were statistically significant (P<0.05);3 days after surgery,GSH-Px and SOD in observation group were higher than those in control group,and ACTH was lower than that of control group (P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05).Conclusion:Compared with traditional TLIF in the treatment of senile LSS with Mast Quadrant,MIS-TLIF has less surgical trauma and less intraoperative stress reaction,which can effectively reduce postoperative pain and improve lumbar function.
万方数据
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