摘要
目的探讨一期附加后路椎弓根螺钉(posterior pedicle screws,PPS)内固定对斜外侧腰椎椎间融合(oblique lateral interbody fusion,OLIF)术后早期融合器(Cage)沉降的影响。方法回顾性收集2016年1月至2019年12月在浙江大学医学院附属邵逸夫医院骨科采用OLIF治疗的腰椎退变性疾病118例患者的临床资料,按手术方式分为单纯OLIF(stand-alone)组58例和OLIF附加PPS固定组60例。患者术前均摄腰椎正侧位X线片,并行CT及MR扫描检查。术后即刻及1、3、6、12月随访,比较两组患者的临床疗效及再手术率,行X线及CT检查评估两组患者在术后各次随访时的Cage沉降情况。结果两组患者的基线资料和手术节段均无统计学差异。118例患者中,141个椎间盘顺利完成OLIF手术,其中58例、68个椎间盘行OLIF stand-alone手术;60例、73个椎间盘行OLIF附加PPS固定手术。两组的手术时间相比差异有统计学意义(P<0.05);两组术中出血量及并发症发生情况、术后临床疗效无统计学差异(P>0.05);Cage沉降率单纯OLIF组为22.41%,OLIF附加PPS固定组为5%,相比有统计学差异(P<0.01);两组的再手术率有统计学差异(P<0.05);末次随访时两组的融合率无统计学差异(P>0.05)。结论OLIF stand-alone和OLIF附加PPS固定均能获得良好的早期临床疗效,一期附加PPS固定能显著减少OLIF术后早期Cage下沉的发生。
Objective To investigate the effects of one-stage additional posterior pedicle screws(PPS)internal fixation on early Cage subsidence after oblique lateral interbody fusion(OLIF).Methods We made a retrospective analysis of 118 patients with lumbar degenerative diseases treated with OLIF at the Department of Orthopedics,Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,from January 2016 to December 2019.We divided the patients into OLIF stand-alone group(58 ones)and OLIF with PPS fixation group(60 ones)according to the surgical procedure.All the patients had preoperative frontal and lateral radiographs of the lumbar spine,and CT and MR scans were performed.The clinical outcomes and reoperation rates of the two groups were compared at immediate postoperative follow-up and at 1,3,6 and 12 months.X-ray and CT examinations were performed to assess Cage subsidence in both groups at each postoperative follow-up.Results There was no statistical difference between the two groups in baseline data and surgical segmentation.Of the 118 patients with 141 discs who underwent OLIF surgery,58 patients with 68 discs received OLIF stand-alone surgery and 60 ones with 73 discs received OLIF with PPS fixation.There were no significant differences in intraoperative bleeding,complications,or postoperative clinical outcomes between the two groups(P>0.05),and the Cage subsidence rate was 22.4%in OLIF stand-alone group and 5%in OLIF with PPS fixation group,with significant difference between the two groups(P<0.01).Conclusion Both OLIF stand-alone and OLIF additional PPS fixation can achieve good early clinical outcomes,and first-stage additional PPS fixation can significantly reduce the occurrence of Cage subsidence in the early postoperative period after OLIF.
作者
李杰
陈意磊
干开丰
陈斌辉
郑敏哲
潘凌霄
刘军辉
范顺武
赵凤东
LI Jie;CHEN Yilei;GAN Kaifeng;CHEN Binhui;ZHENG Minzhe;PAN Lingxiao;LIU Junhui;FAN Shuwu;ZHAO Fengdong(Department of Orthopedic Surgery,Ningbo Medical Center Li Huili Hospital,Ningbo 315000;Department of Orthopedic Surgery,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine/Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province,Hangzhou 310016,China)
出处
《西安交通大学学报（医学版）》
CAS
CSCD
北大核心
2022年第1期111-116,共6页
Journal of Xi’an Jiaotong University（Medical Sciences）
基金
浙江省医药卫生科技计划项目(No.2018KY725)
宁波市自然科学基金资助项目(No.202003N4279)。
关键词
椎弓根螺钉
斜外侧腰椎椎间融合术
融合器沉降
pedicle screw
oblique posterolateral lumbar interbody fusion(OLIF)
Cage subsidence
