摘要
目的比较斜外侧椎间融合术(OLIF)与后路椎间融合术(PLIF)治疗单节段腰椎管狭窄症(LSS)的临床疗效。方法回顾性分析2017年6月~2019年6月山西医科大学附属人民医院收治的50例单节段LSS患者临床资料,其中行OLIF 22例,行PLIF 28例。OLIF组中男性10例,女性12例,年龄(62.1±10.2)岁;PLIF组男性14例,女性14例,年龄(60.5±12.2)岁。比较分析两组患者的住院时长,下地时间,血红蛋白(Hb)减少量,切口长度,手术用时,术中出血量,术前、术后视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI),椎管的矢状径(APD)和横断面积(CSA),前后缘椎间隙高度和椎间孔的高、宽度。结果OLIF组住院时间、下地时间、Hb减少量、切口长度、术中出血量、手术时间均短于PLIF组,差异有统计学意义(P<0.05)。OLIF组术后1月VAS评分低于PLIF组,术后1年后缘椎间隙高度优于PLIF组(均P<0.05)。OLIF组腰大肌损伤、术后Cage沉降、左下肢麻木疼痛各1例;PLIF组感染1例,短暂性下肢麻疼伴腰痛2例,切口发红伴水疱2例,脑脊液漏1例。OLIF组21例融合,融合率95.24%;PLIF组28完全融合,融合率100%。结论OLIF治疗LSS患者具有椎间隙后缘高度恢复更高、康复快、出血少、创伤小等优点,但PLIF融合率更佳,使神经根能极好可视化,从而确保神经根减压彻底;故OLIF并不能完全替代PLIF。
Objective To compare the clinical efficacy of oblique lumbar interbody fusion(OLIF)and posterior lumbar interbody fusion(PLIF)in patients with lumbar spinal stenosis(LSS).Methods 50 patients with LSS treated in the People's Hospital of Shanxi Medical Unviersity from June 2017 to June 2019 were studied retrospectively.22 cases of OLIF and 28 cases of PLIF were performed in the spine diseased area.Among them,there were 10 males and 12 females in the OLIF group,aged(62.1±10.2)years old,14 man and 14 woman in the PLIF,aged(60.5±12.2)years old.The hospital stays,time for ambulation,hemoglobin(Hb)decline,the extent of surgical incision,surgery time,and blood drop during surgery,preoperative and postoperative visual analogue scale(VAS),Oswestry disability index(ODI),anteroposterior diameter(APD)and cross-sectional area(CSA)of spinal canal,the width of the intervertebral foramen,the height of the intervertebral space and the intervertebral foramen were compared between the OLIF and the PLIF group.Results The hospital stays,time for ambulation,hemoglobin(Hb)decline,the extent of incision,surgery time,and blood loss during surgery in the OLIF group were less than those in the PLIF group(P<0.05).The score of VAS in the OLIF group was less than PLIF after a month which was statistically significant(P<0.05).One year later,PDH in the OLIF group was better than the PLIF group which was statistically significant(P<0.05),there were no statistically significant differences in the other imaging indicators between two groups(P>0.05).In terms of postoperative complications,in the OLIF group,there was 1 case of psoas major injury,1 case of postoperative cage subsidence,and 1 case of numbness and pain in the left lower limb,in the PLIF group 2 cases of transient leg pain,1 case of infection,and 2 cases of incision redness with blisters and 1 case of cerebrospinal fluid leakage.Conclusion The efficacy of OLIF in LSS patients is comparable to that of PLIF,with higher recovery of posterior margin height of intervertebral space,faster re
作者
原静晨
宋洁富
王小健
安奇君
马技
梁庆元
赵中涛
YUAN Jingchen;SONG Jiefu;WANG Xiaojian;AN Qijun;MA Ji;LIANG Qingyuan;ZHAO Zhongtao(Shanxi Medical University, Taiyuan 030001, China;The People's Hospital of Shanxi Medical University, Taiyuan 030012, China)
出处
《西部医学》
2021年第8期1165-1169,共5页
Medical Journal of West China
基金
山西省重点研发计划项目(201803D31160)。
关键词
椎间融合术
后入路
斜外侧入路
腰椎管狭窄症
Lumbar interbody fusion
Oblique lumbar interbody fusion
Posterior lumbar interbody fusion
Lumbar spinal stenosis
