Observation on the short-term effects of decompression combined with fusion and internal ifxation in the treatment of lumbar spinal stenosis

SUN Yan; QIN Aiping; LIU Xiwei

Abstract：ObjectiveTo observe the short-term effects of decompression and fusion combined with internal fixation in the treatment of lumbar spinal stenosis.MethodsThirty-five patients with lumbar spinal stenosis who underwent decompression and fusion combined with internal fixation in Xi'an Red Cross Hospital were included in the combination group. Another thrity cases of patients who underwent simple decompression in the same period were included in the simple decompression group. The patients were followed up for 12 to 32 months after surgery. The operation time, intraoperative blood loss, clinical curative effect, VAS scores before surgery and during the last follow-up, relative lumbar space height, lumbar lordosis and changes of CSSS scores were compared between the two groups. The incidence of ASD in the combination group was statistically analyzed in the last follow-up.ResultsThe average operation time was much shorter and intraoperative blood loss was much less severe in the simple decompression group than those in the combination group (P<0.05). During the last follow-up, the excellent rate in the simple decompression group was not significantly different from that in the combined group (P>0.05), the relative lumbar space height of the simple decompression group was significantly lower than that of the combination group (P<0.05), and VAS scores of the two groups were significantly lower than those before surgery (P<0.05), but there was no significant difference in lumbar lordosis between the two groups before and after treatment (P>0.05). In the last follow-up, the severity of symptoms and postoperative satisfaction score in the observation group were significantly lower than those in the simple decompression group (P<0.05). The incidence of ASD in the combination group was 8.57%.ConclusionThe medium-term curative effect of decompression and fusion combined with internal fixation in the treatment of lumbar spinal stenosis is similar to that of simple decompression. However, the former has obvious advantages in maintaining relatively higher lumbar space height and relieving the severity of symptoms,though ASD occurs after combined therapy.