Zhongguo linchuang yanjiu (May 2024)
Improvement of lumbar spine function in patients with lumbar spinal stenosis by spinal endoscopic bilateral decompression of the spinal canal with unilateral interlaminar approach
Abstract
Objective To analyze the effect of spinal endoscopic unilateral interlaminar approach with bilateral decompression of the spinal canal in the improvement of lumbar spine function in patients with lumbar spinal stenosis (LSS). Methods A total of 82 patients with LSS admitted in Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from August 2021 to August 2023 were selected and divided using the randomized numerical table method, in which 41 patients were treated with spinal endoscopic percutaneous interlaminar approach decompression of the spinal canal (control group), and 41 patients were treated with spinal endoscopic unilateral interlaminar approach bilateral decompression of the spinal canal (study group). The surgical indexes, lumbar spine function, pain level, imaging indexes, microinflammatory factors of the spinal canal, oxidative stress indexes, therapeutic effects and complications were compared between the two groups. Results Compared with the control group, the study group had a shorter operation time and bedtime, less intraoperative bleeding, lower herniation encroachment ratio and higher spinal canal area (P＜0.05). At 24 h after surgery, in study group, monocyte chemotactic protein-1 (MCP-1) , interleukin (IL)-1β, IL-1α, serum malondialdehyde (MDA) were lower than those of the control group (P＜0.05), while the levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were higher than those of the control group (P＜0.05). The excellent rate of MacNab in the study group was higher than that in the control group (92.68% vs 75.61%, χ2=4.479, P＜0.05), and the total incidence of complications was lower than that in the control group (4.88% vs 19.51%, χ2=4.100, P＜0.05). Conclusion Both percutaneous intervertebral foraminal approach and unilateral interlaminar approach have good therapeatic effects in LSS patients, but spinal endoscopic unilateral interlaminar approach with bilateral decompression of the spinal canal is better, which is conducive to the improvement of lumbar spine function, reduce the degree of lumbar pain, spinal canal microinflammatory injury and oxidative stress injury, and reduce complications, and the clinic can be further popularized and applied.
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