首页|斜外侧入路与经椎间孔椎间融合术治疗退行性腰椎滑脱2年随访结果的对比研究

斜外侧入路与经椎间孔椎间融合术治疗退行性腰椎滑脱2年随访结果的对比研究

扫码查看
目的 比较斜外侧入路椎间融合术(oblique lumbar interbody fusion,OLIF)和经椎间孔椎间融合术(transforaminal lumbar interbody fusion,TLIF)治疗退行性腰椎滑脱术后2年的临床疗效。方法 回顾性分析2017年7月~2020年9月OLIF(46例)和TLIF(45例)治疗退行性腰椎滑脱2年随访资料,融合范围1~2个腰椎节段。主要观察指标为术后2年疼痛视觉模拟量表(Visual Analogue Scale,VAS)和Oswestry功能障碍指数(Oswestry Disability Index,ODI),次要观察指标为术后2年影像学参数、椎间融合、融合器沉降和永久性神经损伤发生率。结果 OLIF和TLIF术后2年腰痛VAS[2(2,3)vs。2(2,2),P=0。943]、下肢痛 VAS[2(2,2)vs。2(2,2),P=0。988]和 ODI[17%(10%,22%)vs。14%(10%,22%),P=0。417]差异均无显著性。OLIF术后2年椎间高度优于TLIF[(11。9±1。5)mm vs。(9。2±2。0)mm,P<0。001],节段前凸角度优于TLIF(15。7°±7。2° vs。12。5°±5。9°,P=0。029),且融合器沉降率低[19。6%(9/46)vs。40。0%(16/40),P=0。037]。2 组术后2 年融合率[93。5%(43/46)vs。87。5%(35/40),P=0。562]和永久性神经损伤发生率[4。3%(2/46)vs。6。7%(3/45),P=0。980]差异均无显著性。结论 对于退行性腰椎滑脱,短节段OLIF和TLIF术后2年在症状改善和融合率方面表现相似,但OLIF椎间高度和前凸角度恢复更显著,且融合器沉降率较低。
A Comparative Study of Oblique and Transforaminal Lumbar Interbody Fusion for Degenerative Spondylolisthesis at Postoperative 2 Years
Objective To compare the clinical outcomes between oblique lumbar interbody fusion(OLIF)and transforaminal lumbar interbody fusion(TLIF)for patients with degenerative spondylolisthesis during 2-year follow-ups.Methods Patients with symptomatic degenerative spondylolisthesis who underwent OLIF(46 cases)and TLIF(45 cases)between July 2017 and September 2020 with 2-year follow-ups were retrospectively reviewed.One level or two-level lumbar fusion were included.The primary outcomes were Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)at 2 years after surgery.The secondary outcomes included radiographic parameters,fusion rate,cage subsidence rate,and permanent nerve injury rate.Results No significantly different changes were noted in VAS-back[2(2,3)vs.2(2,2),P=0.943],VAS-leg[2(2,2)vs.2(2,2),P=0.988],and ODI[17%(10%,22%)vs.14%(10%,22%),P=0.417]between the OLIF group and the TLIF group,respectively.Greater restoration of disc height and segmental lordosis were obtained in the OLIF group[mean,(11.9±1.5)mm and 15.7°±7.2°]than in the TLIF group[mean,(9.2±2.0)mm and 12.5°±5.9°]at postoperative 2-year(P<0.001 and P=0.029).The subsidence rate was lower in the OLIF group than in the TLIF group[19.6%(9/46)vs.40.0%(16/40),P=0.037].The fusion rates at postoperative 2-year were 93.5%(43/46)in the OLIF group and 87.5%(35/40)in the TLIF group,having no significant difference(P=0.562).The rates of permanent nerve injury were similar between the two groups[4.3%(2/46)vs.6.7%(3/45),P=0.980]at postoperative 2-year.Conclusion Short segment OLIF doesn't show better clinical outcomes and fusion rate than TLIF for degenerative spondylolisthesis,except for greater disc height restoration,greater segmental lordosis,and lower subsidence rate at postoperative 2-year.

Interbody fusionOblique lumbar interbody fusionLumbar spondylolisthesisComparative study

吴静晔、葛腾辉、李观清、敖进涛、徐忠宁、孙宇庆

展开 >

首都医科大学附属北京积水潭医院脊柱外科,北京 100035

椎间融合术 斜外侧入路椎间融合术 腰椎滑脱 对比研究

国家重点研发计划国家重点研发计划

2022YFC24072002022YFC2407204

2024

中国微创外科杂志
北京大学

中国微创外科杂志

CSTPCD北大核心
影响因子:2.21
ISSN:1009-6604
年,卷(期):2024.24(9)