微创医学

目的观察中医药综合技术结合椎间孔镜下峡部植骨联合经皮弓根螺钉内固定术治疗青年腰椎峡部裂的临床效果。方法选取2015年6月至2022年10月广西中医药大学第一附属医院收治的30例腰椎峡部裂青年患者，采用随机数字表法将患者分为观察组15例，对照组15例。两组患者均在椎间孔镜下行峡部植骨联合椎弓根螺钉内固定术治疗，观察组加用中医药综合技术治疗。比较两组患者的手术时间、术中出血量、术后下床活动时间、术后住院时间、疼痛视觉模拟量表（VAS）评分、腰椎Oswestry功能障碍指数（ODI）评分。结果两组患者的手术时间、术中出血量比较，差异均无统计学意义（均P>0.05）。观察组患者的术后下床活动时间早于对照组，术后住院时间短于对照组，差异均有统计学意义（均P<0.05）。疼痛方面，两组VAS评分差异无统计学意义（P>0.05）；两组VAS均随时间呈下降趋势（P<0.05）；干预措施与时间存在交互效应（P<0.05）。腰椎功能障碍方面，两组ODI评分差异无统计学意义（P>0.05）；两组ODI评分均随时间呈下降趋势（P<0.05）；不同治疗方案与时间存在交互效应（P<0.05）。结论采用中医药综合技术结合椎间孔镜下峡部植骨联合经皮椎弓根螺钉内固定术治疗青年腰椎峡部裂，有利于缓解疼痛症状，能够加快患者腰部功能康复，缩短住院时间，值得推广应用。

Objective To observe the clinical effect of comprehensive traditional Chinese medicine techniques combined with isthmic bone grafting under intervertebral foraminal endoscopy and percutaneous pedicle screw internal fixation for the treatment of lumbar spondylyosis in young patients. Methods A total of 30 young patients with lumbar spondylolysis admitted to the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from June 2015 to October 2022 were selected. The patients were divided into observation group (15 cases) and control group (15 cases) by random number table method. Both groups underwent isthmic bone grafting combined with pedicle screw internal fixation under intervertebral foraminal endoscopy. Additionally, the observation group received comprehensive traditional Chinese medicine treatment. The two groups were compared in terms of operation time, intraoperative blood loss, postoperative ambulation time, postoperative hospital stay, visual analogue scale (VAS) score, and lumbar Oswestry disability index (ODI) score. Results There was no statistically significant difference in the operation time and intraoperative blood loss between the two groups (all P>0.05). The observation group had an earlier postoperative ambulation time and a shorter postoperative hospital stay compared to the control group, with statistically significant differences (all P<0.05). In terms of pain, there was no significant difference in VAS score between the two groups (P>0.05). The VAS of both groups decreased significantly over time (P<0.05). Moreover, there was an interaction effect between intervention and time (P<0.05). In terms of lumbar dysfunction, the ODI scores did not show a significant difference between the two groups (P>0.05). The ODI scores of both groups demonstrated a downward trend as time progressed (P<0.05). Additionally, a interaction effect was found between the different treatment regimens and time (P<0.05). Conclusion The combination of comprehensive traditional Chinese medicine techniques and minimally invasive surgery for treating lumbar spondylyosis in young patients is effective in relieving pain symptoms, accelerating the recovery of lumbar function, and reducing the hospital stay, which is worthy of promotion and application.