摘要
目的探究微创侧方入路腰椎椎间融合术(extreme lateral interbody fusion,XLIF)与微创侧前方人路腰椎椎间融合术(oblique lateral lumbar interbody fusion,OLIF)对退变性脊柱侧凸患者功能恢复的影响,为临床上退变性脊柱侧凸的治疗方式选择提供参考。方法选取2016年1月-2019年1月宁波大学医学院附属医院收治的行手术治疗的退变性脊柱侧凸患者100例,按术式分为XLIF组(56例)、0LIF组(44例)。XLIF组行XLIF术,0LIF组行OLIF术。对比2组临床指标、脊柱侧凸Cobbs角.PI-LL.功能恢复.疼痛、并发症发生情况。结果OLIF组术后6个月侧凸Cobb's角、PI-LL分别为(5.00±1.10)°、(13.52±2.13)°,低于XLIF组的(5.12±1.09)°、(13.68±2.15)°,差异无统计学意义(t=0.5440.371,P=0.587.0.712)。OLIF组术后6个月D0I、NRS评分分别为(8.00±0.50)分、(1.13±0.02)分,低于XLIF组的(11.27±0.68)分、(2.49±0.10)分(t=26.710.99.277,均P<0.001);OLIF组术后6个月J0A评分为(25.66±3.58)分,高于XLIF组的(19.68±2.46)分(1=9.884,P<0.001)。OLIF组患者手术并发症发生率为2.27%,低于XLIF组的17.86%(x=4.625,P=0.032)。结论与XLIF术相比,0LIF术可减轻退变性脊柱侧凸患者腰椎疼痛症状,促进功能恢复,且安全性较高,值得临床推广应用。
Objective To explore the efects of minimally invasive extreme lateral interbody fusion(XILIF)and minimal-ly invasive oblique lateral lumbar interbody fusion(OLIF)on the functional recovery of patients with degenerative scolio-sis,and to provide a reference for the choice of treatment of degenerative scoliosis.Methods Total 100 patients with degenerative scoliosis who were operated in our hospital from January 2016 to January 2019 were divided into XLIF group(56 cases)and OLIF group(44 cases).XLIF was performed in XLIF group and OLIF in OLIF group.The clinical inde-xes,Cobb's angle,PI-LL,functional recovery,pain and complications were compared between the two groups.Results Six month after operation,the Cobbs angle and PI-LL[(5.00±1.10)d,(13.52±2.13)°]in the OLIF group were lower than those in the XLIF group[(5.12±1.09)°,(13.68±2.15)°],with no significant difference(1=0.544,0.371;P=0.587,0.712).The D0I and NRS scores(8.00±0.50,1.13±0.02)in the OLIF group were lower than those in the XLIF group(11.27±0.68,2.49±0.10,t=26.710,88.740,all P<0.01).The JOA score(25.66±3.58)of the OLIF group was higher than that of the XLIF group(19.68±2.46,t=9.884,P=0.001).The ineidence of operative complications in the OLIF group(2.27%)was lower than that in the XLIF group(17.86%,x=4.625,P=0.032).Conclusion Compared with XLIF,OLIF can significantly reduce the symptoms of lumbar pain in patients with degenerative scoliosis,promote the recovery of function,and has higher safety,which is worthy of clinical application.
作者
韦勇力
罗科锋
赵霁
WEI Yong-li;LUO Ke-feng;ZHAO Ji(Department of Spine,the Afiliated Hospital of Medicine School of Ningbo University,Ningbo,Zhejiang 315020,China)
出处
《中华全科医学》
2020年第10期1649-1651,1698,共4页
Chinese Journal of General Practice
基金
浙江省医药卫生科技计划项目(2020KY872)。
关键词
微创侧方入路腰椎椎间融合术
微创侧前方入路腰椎椎间融合术
退变性脊柱侧凸
功能恢复
Minimally invasive lateral approach lumbar interbody fusion
Minimally invasive lateral anterior approach lumbar interbody fusion
Degenerative scoliosis
Functional recovery
