| 张文彬,吕良友,王志鹏,林志宏*.斜外侧椎间融合术与微创经椎间孔入路腰椎椎间融合术治疗单节段轻中度腰椎滑脱的临床疗效[J].脊柱外科杂志,2023,21(1):26-31. |
斜外侧椎间融合术与微创经椎间孔入路腰椎椎间融合术治疗单节段轻中度腰椎滑脱的临床疗效  点此下载全文 (Fulltext) |
| 张文彬 吕良友 王志鹏 林志宏* |
| 同安区中医医院骨科, 厦门 361100 |
| 基金项目： |
| DOI：10.3969/j.issn.1672-2957.2023.01.005 |
| 摘要点击次数: 363 |
| 全文下载次数: 86 |
| 摘要： |
| 目的 比较斜外侧椎间融合术（OLIF）与微创经椎间孔入路腰椎椎间融合术（MIS-TLIF）治疗单节段轻中度腰椎滑脱的临床疗效和影像学结果。方法 2015年2月—2018年2月，收治单节段轻中度腰椎滑脱患者48例，其中22例采用OLIF治疗（OLIF组），26例采用MIS-TLIF治疗（MIS-TLIF组）。记录2组手术时间、术中出血量、住院时间及并发症发生情况；术前及术后1周、1个月、6个月及末次随访时采用疼痛视觉模拟量表（VAS）评分和Oswestry功能障碍指数（ODI）评估腰腿痛程度及腰椎功能。术前及末次随访时在影像学资料上测量腰椎前凸角（LL）、手术节段Cobb角、椎间高度（DH）、椎管横截面积（CSA）及椎间孔面积（FA）。结果 所有手术顺利完成，所有患者随访24~45个月，平均32.8个月。OLIF组手术时间、术中出血量及住院时间明显少于MIS-TLIF组，差异均有统计学意义（P < 0.05）。2组术后各随访时间点VAS评分和ODI较术前明显改善，差异均有统计学意义（P < 0.05）；术后1周OLIF组VAS评分和ODI优于MIS-TLIF组，差异均有统计学意义（P < 0.05）。2组末次随访时LL、手术节段Cobb角、DH、椎管CSA和FA较术前明显改善，差异均有统计学意义（P < 0.05）；末次随访时OLIF组LL、手术节段Cobb角、DH和FA矫正值优于MIS-TLIF组，差异均有统计学意义（P < 0.05）。结论 与MIS-TLIF相比，OLIF治疗单节段轻中度腰椎滑脱具有手术时间短、术中出血量少、更好地恢复腰椎生理曲度、早期缓解疼痛、恢复腰椎功能等优势，值得临床推广使用。 |
| 关键词：腰椎 脊椎滑脱 脊柱融合术 外科手术,微创性 |
| Clinical efficacy of oblique lumbar interbody fusion and minimally invasive transforaminal lumbar interbody fusion in treatment of single-level mild to moderate lumbar spondylolisthesis Fulltext |
| Zhang Wenbin Lü Liangyou Wang Zhipeng Lin Zhihong* |
| Department of Orthopaedics, Tongan District Hospital of Traditional Chinese Medicine, Xiamen 361100, Fujian, China |
| Fund Project: |
| Abstract: |
| Objective To compare the clinical efficacy and imaging results of oblique lumbar interbody fusion(OLIF) and minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF) in the treatment of single-level mild to moderate lumbar spondylolisthesis. Methods From February 2015 to February 2018, 48 patients with single-level mild to moderate lumbar spondylolisthesis were treated, including 22 patients treated with OLIF(OLIF group) and 26 with MIS-TLIF(MIS-TLIF group). The operation time, intraoperative blood loss, hospital stay and complications of the 2 groups were recorded. The pain visual analogue scale(VAS) score and Oswestry disability index(ODI) were used to evaluate the intensity of low back and leg pain and lumbar function before operation and postoperative 1 week, 1 month, 6 months and at the final follow-up. The lumbar lordosis angle(LL), Cobb angle of the operative segment, disc height(DH), spinal canal cross-sectional area(CSA) and foraminal area(FA) were measured on the imaging data before operation and at the final follow-up. Results All the operations were successfully completed. All the patients were followed up for 24-45 months, with an average of 32.8 months. The operation time, intraoperative blood loss and hospital stay in the OLIF group were significantly shorter than those in the MIS-TLIF group, and the differences were statistically significant(P < 0.05). The VAS score and ODI at each follow-up time point in the 2 groups were significantly improved compared with those before operation, all with a statistically significant difference(P < 0.05);at postoperative 1 week, the VAS score and ODI in the OLIF group were better than those in the MIS-TLIF group, and the differences were statistically significant(P < 0.05). The LL, Cobb angle of operative segment, DH, spinal canal CSA and FA at the final follow-up were significantly improved in both groups compared with those before operation, all with a statistically significant difference(P < 0.05);at the final follow-up, the corrected values of LL, Cobb angle of operative segment, DH and FA in the OLIF group were better than those in the MIS-TLIF group, and the differences were statistically significant(P < 0.05). Conclusion Compared with MIS-TLIF, OLIF has the advantages of short operation time, less intraoperative blood loss, better recovery of lumbar physiological curvature, early pain relief and recovery of lumbar function in the treatment of single-level mild to moderate lumbar spondylolisthesis, thus being worthy of wider clinical application. |
| Keywords:Lumbar vertebrae Spondylolysis Spinal fusion Surgical procedures,minimally invasive |
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