摘要
目的 观察斜外侧腰椎间融合联合后路经皮椎弓根钉内固定治疗退行性腰椎滑脱症的临床疗效和脊柱-骨盆矢状面参数变化情况。方法 回顾性分析自2017-07—2021-05采用斜外侧腰椎间融合联合后路经皮椎弓根钉内固定治疗的25例退行性腰椎滑脱症,比较手术前后疼痛VAS评分及ODI指数,手术前后矢状面轴向距离(SVA)、骨盆入射角(PI)、骨盆倾斜角(PT)、骶骨倾斜角(SS),手术前后椎间隙高度(DH)、椎间孔高度(FH)、腰椎前凸角(LL)、融合节段前凸角(FSL)。结果 25例均获得随访,随访时间12~15个月,中位时间12个月。末次随访时4例出现融合器下沉(0级3例,Ⅰ级1例),1例邻近节段退行性改变。末次随访时3例仍存在Meyerding Ⅰ度滑脱,22例腰椎滑脱被矫正。术后第3天疼痛VAS评分、ODI指数较术前降低,术后1个月、末次随访时持续降低(P<0.05)。术后第3天SVA较术前减小,末次随访时较术后第3天减小(P<0.05)。术后第3天DH、FH较术前增加,而术后3个月DH、FH较术后第3天减小,差异有统计学意义(P<0.05);末次随访时DH、FH与术后3个月比较差异无统计学意义(P>0.05)。术后1个月LL较术前增加(P<0.05),但是术后1个月、术后3个月、末次随访LL比较差异无统计学意义(P>0.05)。手术前后PI、PT、SS、FSL比较差异无统计学意义(P>0.05)。结论 斜外侧腰椎间融合联合后路经皮椎弓根钉内固定治疗退行性腰椎滑脱症的临床疗效确切,在较小损伤的前提下恢复并维持椎间隙高度、椎间孔高度和腰椎前凸角,有效改善患者临床症状。
Objective To observe the clinical efficacy of oblique lateral lumbar interbody fusion combined with posterior per-cutaneous pedicle screw in the treatment of degenerative lumbar spondylolisthesis and the changes of spino-pelvic sagittal pa-rameters.Methods Twenty-five patients with degenerative lumbar spondylolisthesis treated with oblique lateral interbody fu-sion combined with posterior percutaneous pedicle screw from July 2017 to May 2021 were retrospectively analyzed.The VAS score,ODI index,sagittal vertical axis(SVA),pelvic incidence(PI),pelvic tilt(PT),sacral slope(SS),disc height index(DH),foraminal height(FH),lumbar lordosis(LL)and fusion segment lordosis(FSL)before and after operation were compared.Re-sultsAll patients were followed up for 12-15 months,with a median time of 12 months.There were 4 cases of cage subsidence(3 cases of grade O,1 case of grade I)and 1 case of adjacent segment degeneration during final follow-up.At the final follow-up,3 cases still had grade I spondylolisthesis,and 22 cases were corrected.The VAS score and ODI index were significantly lower than those before operation on the third day after operation,and continued to decrease at 1 month after operation and last follow-up(P<0.05).SVA at third day after operation was significantly lower than that before operation,and it was significantly lower at last follow-up than that at third day after operation(P<0.05).DH and FH increased on the third day after operation,while DH and FH decreased on the 3 months after operation,and the differences were statistically significant(P<0.05).There was no sig-nificant difference in DH and FH between at last follow-up and at 3 months after operation(P>0.05).The LL at 1 month after operation was significantly higher than that before operation(P<0.05).There was no significant difference in LL at 1 month after operation,3 months after operation,and the last follow-up(P>0.05).There was no significant difference in PI,PT,SS,and FSL between before and after operation(P>0.05).Conclusion The clinical effec
作者
江雨剑
刘晨
肖良
李逸峰
张玙
吴仲宣
耿寅
JIANG Yujian;LIU Chen;XIAO Liang;LI Yifeng;ZHANG Yu;WU Zhongxuan;GENG Yin(Department of Spine Surgery,Yijishan Hospital,the First Afiliated Hospital of Wannan Medical College,Wuhu,Anhui 241001,China)
出处
《中国骨与关节损伤杂志》
2023年第3期247-251,共5页
Chinese Journal of Bone and Joint Injury
基金
安徽省自然科学基金项目(2208085MH211)。
关键词
退行性腰椎滑脱症
斜外侧腰椎间融合术
经皮椎弓根钉内固定
脊柱-骨盆矢状面参数
Degenerative lumbar spondylolisthesis
Oblique lateral interbody fusion
Percutaneous pedicle screw fixation
Spine-pelvic sagittal parameters
