OLIF联合后路经皮固定术治疗腰椎退变性滑脱疗效观察  

Clinical Effect of OLIF Combined with Posterior Percutaneous Internal Fixation for Lumbar Spondylolisthesis

作　　者：李建江[1] 白涛[1] 胡炜[1] 黄异飞[1] 韩念荣 LI Jian-jiang;BAI Tao;HU Wei;HUANG Yi-fei;HAN Nian-rong(The Center of Spine,The Fourth Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,Xinjiang,China)

机构地区：[1]新疆医科大学第四附属医院脊柱中心,乌鲁木齐830000

出　　处：《中国现代手术学杂志》2021年第3期182-187,共6页Chinese Journal of Modern Operative Surgery

摘　　要：目的观察OLIF加后路经皮固定术治疗腰椎退变性滑脱的早期临床疗效。方法回顾性分析2016年9月至2019年5月在我院手术治疗的41例L4椎Ⅰ~Ⅱ度退变性滑脱患者的临床资料,其中20例行斜外侧腰椎椎间融合术(OLIF)加后路经皮固定术(OLIF组),21例行微创经椎间孔腰椎椎间融合术(MIS-TLIF组)。观察两组患者围手术期结果,采用X线片测量椎间隙高度、下腰椎前凸角,采用疼痛视觉模拟评分(VAS)评估患者腰痛状况,采用Oswestry功能障碍指数(ODI)行功能评价。结果两组均顺利完成手术。OLIF组手术时间、术中出血量及术后住院时间均明显少于MIS-TLIF组,差异有统计学意义(P<0.05)。41例患者均获随访,随访时间为6个月。所有患者复查X线片示融合器固定牢固,无明显移位,椎弓根螺钉无断裂及松动。两组患者术后即刻及术后6个月椎间高度、下腰椎前凸角、腰痛VAS评分及ODI指数均较术前明显改善,差异有统计学意义(P<0.05);组间比较,OLIF组术后即刻及术后6个月椎间隙高度、下腰椎前凸角较MIS-TLIF组显著增加,差异有统计学意义(P<0.05),而两组VAS评分及ODI指数比较,差异均无统计学意义(P>0.05)。结论OLIF加后路经皮固定术治疗L4椎Ⅰ、Ⅱ度退变性滑脱手术创伤小,临床疗效可靠,值得推广应用。Objective To evaluate the short-term clinical effect of oblique lateral interbody fusion(OLIF)combined with posterior percutaneous internal fixation for degenerative spondylolisthesis of L4 with degreeⅠtoⅡ.Methods A retrospective analysis was performed on 41 patients withⅠtoⅡdegenerative lumbar spondylolisthesis in our hospital from September 2016 to May 2019.The surgery of OLIF combined with posterior percutaneous internal fixation was performed in 21 cases(as the OLIF group),and mini-invasive transforaminal lumbar interbody fusion(MIS-TLIF)was carried out in other 21 cases(as the MIS-TLIF group).The peri-operative time,length of hospital stays and intra-operative blood loss were observed and recorded,the height of intervertebral space,lower lumbar lordosis angle were examined by X ray,and the visual analogue scale(VAS)and the Oswestry disability index(ODI)was applied to assess low-back pain and function respectively in the both groups.Results The surgical operation was successful in both groups.Compare to the MIS-TLIF group,the operation time and post-operative hospital stays were shorter and the intra-operative blood loss was less in the OLIF group(P<0.05).All patients were followed up for 6 months.The post-operative X-ray revealed that the fusion device was firmly fixed without obvious displacement,broken and loosening of pedicle screw.The height of intervertebral space,lower lumbar lordosis angle,VAS score and ODI score were improved significantly after than before the surgery in both groups,and the differences were statistically(P<0.05).Compare to the MIS-TLIF group,the height of intervertebral space and lower lumbar lordosis angle was increased obviously in the OLIF group(P<0.05),but there was no remarkable difference in the VAS score and ODI score between the two groups immediately and 6 months after surgery(P>0.05).Conclusion The surgical intervention of OLIF combined with posterior percutaneous internal fixation can achieve a reliable effect with mini-trauma for degenerative spondylolisthesis of

关 键 词：腰椎滑脱 退行性 斜外侧腰椎间融合术 后路经皮固定术 经腰椎间孔入路椎间融合术 

分 类 号：R681.53[医药卫生—骨科学]