摘要
目的探讨斜外侧椎间融合术(oblique lateral interbody fusion,OLIF)联合经皮内固定术治疗腰椎管狭窄症(lumbar spinal stenosis,LSS)的临床疗效。方法纳入2017年2月~2019年2月本院收治的74例LSS患者,40例采用OLIF手术者设为观察组,34例采用微创经椎间孔入路腰椎椎体间融合术(minimally invasive transforaminal lumbar interbody fusion,MIS-TLIF)者设为对照组。记录两组患者手术、住院以及并发症发生情况,比较术前、术后3个月、术后18个月时椎间高度、椎管面积、VAS评分及ODI指数。结果观察组手术时间、出血量、首次下床时间、住院时间均显著低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,但差异无统计学意义(P>0.05),两组椎间融合率差异无统计学意义(P>0.05);与术前比较,两组术后各随访时间点椎间高度、椎管面积均显著升高,VAS评分、ODI指数显著降低(P<0.05),组间各随访时间点各项指标差异均无统计学意义(P>0.05)。结论与MIS-TLIF手术比较,OLIF手术治疗LSS创伤更小,能缩短下床及住院时间,并获得良好的椎管间接减压效果,近期疗效确切。
Objective To explore the clinical effect of oblique lateral interbody fusion(OLIF)combined with percutaneous internal fixation in the treatment of lumbar spinal stenosis(LSS).Methods Seventy-four patients with LSS in our hospital from February 2017 to February 2019 were included in this study.They were divided into two groups according to different intervertebral fusion procedures.Forty patients who underwent OLIF combined with percutaneous internal fixation were set as the observation group,and 34 patients who underwent minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)combined with percutaneous internal fixation were set as the control group.The operation,hospitalization and complications of the two groups were recorded.The intervertebral height,spinal canal area,pain visual analog scale(VAS)and Oswestry dysfunction index(ODI)were compared before operation,at 3,18 months after operation.Results The operation time,blood loss,time to get out of bed for the first time,and hospital stay in the observation group were significantly lower than those in the control group(P<0.05).The incidence rate of complications in the observation group was lower than that in the control group,but the difference was not statistically significant(P>0.05),and there was no significant difference in the intervertebral fusion rate between the two groups(P>0.05).Compared with preoperation,the intervertebral height and spinal canal area of the two groups were significantly increased at each follow-up time point after surgery,and the VAS score and ODI index were significantly reduced.There were no statistically significant differences in above indicators between the two groups at each follow-up time point(P>0.05).Conclusion Compared with MIS-TLIF,OLIF has less trauma in the treatment of LSS,it can shorten the time of getting out of bed and hospitalization,and obtain a good effect of indirect decompression of the spinal canal.The short-term effect is definite.
作者
吕福洲
汤美玉
郭靖
LU Fu-zhou;TANG Mei-yu;GUO Jing(Wuhan Caidian District People's Hospital(Union Jiangbei Hospital of Huazhong University of science and Technology),Wuhan Hubei 430100,China)
出处
《颈腰痛杂志》
2021年第3期326-329,共4页
The Journal of Cervicodynia and Lumbodynia
基金
宁夏回族自治区自然科学基金(编号:NZ16212)。
关键词
斜外侧椎间融合术
经椎间孔入路腰椎椎体间融合术
经皮内固定
腰椎管狭窄症
oblique lateral interbody fusion
transforaminal lumbar interbody fusion
percutaneous internal fixation
lumbar spinal stenosis
