摘要
目的探讨斜外侧腰椎椎间融合术（OLIF）对腰椎退行性疾病的影像学问接减压效果。方法回顾性分析2016年10月至2017年4月首都医科大学宣武医院神经外科收治的30例腰椎退行性疾病患者的临床资料。所有病例均行OLIF且未行后路减压。测量术前及末次随访的MRIT2WI轴位椎管面积（CSA）以及矢状位CT椎间高度（DH）、椎间孔高度（CSH）、椎间孔面积（CSAF）。采用视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）及36项简易健康状况调查问卷评分（SF-36）评估临床疗效。结果30例患者共行OLIF融合62个节段。术后随访9-15个月，平均（12．5±2．3）个月。术前至末次随访时，CSA由（0．82±0．34）cm。增加至（1．38±0．37）cm^2，DH由（0．68±0．24）cm增加至（1．13±0．29）cm，CSH由（1．53±0．25）cm增加至（2．054-0．32）cm，CSAF由（1．12±0．28）cm^2增加至（1．80±0．37）cm^2，且差异均有统计学意义（均P〈0．01）。末次随访30例患者的VAS、ODI及SF-36均较术前明显改善（均P〈0．05）。仅1例出现腰大肌受损症状。无一例出现脊神经、大血管、腹腔脏器或输尿管损伤。结论OLIF可改善腰椎退行性疾病患者的CSA、DH、CSH、CSAF，获得良好的影像学和临床间接减压效果。
Objective To examine the radiographic efficacy of indirect decompression of oblique lumbar interbody fusion （OLIF） for lumbar degenerated disease. Methods Thirty consecutive patients were enrolled into this study who presented with lumbar degenerated disease and underwent OLIF without posterior decompression from October 2016 to April 2017 at Neurosurgery Department of Xuanwu Hospital, Capital Medical University. The imaging, clinical efficacy and complications were retrospectively reviewed. X-Ray, CT scan and MRI before operation and at the last follow-up were evaluated. The cross-sectional area （CSA） of the thecal sac was measured on T2WI axial MRI. The disk height （DH）, cross-sectional height （CSH） of intervertebral foramina and cross-sectional areas of intervertebral foramina （CSAF） were measured on sagittal view of CT. Visual analog scale （VAS） score, Oswestry disability index （ODI） and medical outcome study 36-item short-form health survey （SF-36） were evaluated before operation and at the last follow-up. Results A total of 62 lumbar levels of OLIF fusion in 30 patients were performed successfully without severe complications. Our follow-up study lasted 9 - 15 months with an average of 12.5 ± 2.3 months. The mean CSA increased from 0.82 ± 0.34 cm^2 preoperatively to 1.38 ± 0.37 cm^2 postoperatively, DH increased from 0.68±0.24 cm preoperatively to 1.13 ± 0.29 cm postoperatively, CSH increased from 1.53 ± 0.25 cm preoperatively to 2.05 ± 0.32 cm postoperatively, and CSAF increased from 1.12 ± 0.28 cm^2 preoperatively to 1.80 ± 0. 37 cm^2 postoperatively （all P 〈 0. 01 ）. The VAS, ODI and SF-36 scores were significantly improved after surgery （ all P 〈 0.05 ）. There was no spinal nerve, major vessel, peritoneal, or urinary injury. Only 1 patient showed symptoms related to psoas invasion. Conclusion Significant improvements in CSA, DH, CSH and CSAF could be obtained following OLIF surgery for degenerated lumbar disease with good clinical and imagine outcome
作者
王凯
菅凤增
孙澎
吴浩
Wang Kai;Jian Fengzeng;Sun Peng;Wu Hao(Department of Neurosurgery,Xuanwu Hospital of Capital Medical University,Beijing 100053,China)
出处
《中华神经外科杂志》
CSCD
北大核心
2018年第7期704-708,共5页
Chinese Journal of Neurosurgery
关键词
脊柱疾病
腰椎
摄影测量法
斜外侧腰椎椎间融合术
治疗结果
Spinal diseases
Lumbar vertebrae
Photogrammetry
Oblique lateral interbodyfusion
Treatment outcome
