Ⅰ、Ⅱ度单节段退行性腰椎滑脱应用OLIF与MIS-TLIF手术的疗效研究  

Study on efficacy of OLIF and MIS-TLIF in the treatment of degreeⅠor degreeⅡsingle-segment degenerative lumbar spondylolisthesis

作　　者：王先辉[1] 王华[1] 陈舰[1] 缪佳庆[1] WANG Xian-hui;WANG Hua;CHEN Jian;MIAO Jia-qing(Department of Orthopaedics,Shanghai Putuo District People's Hospital,Shanghai 200060,China)

机构地区：[1]上海市普陀区人民医院骨科,上海200060

出　　处：《颈腰痛杂志》2022年第3期341-343,347,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：普陀区临床特色专病能力提升项目(编号:2020tszb04)。

摘　　要：目的分析斜外侧椎间融合术(oblique lateral interbody fusion,OLIF)与小切口经椎间孔椎间融合术(minimally invasive transforminal lumbar interbody fusion,MIS-TLIF)治疗Ⅰ、Ⅱ度单节段退行性腰椎滑脱(degenerative lumbar spondylolisthesis,DLS)的疗效。方法回顾性分析76例Ⅰ、Ⅱ度单节段DLS患者临床资料,根据手术方法分为OLIF组(n=35)和MIS-TLIF组(n=41),比较两组患者术中指标、术后指标、影像学指标、手术前后疼痛程度以及腰椎功能。结果OLIF组切口长度、手术时间及下床活动时间、住院时间显著短于MIS-TLIF组,术中出血量、术后引流量显著少于MIS-TLIF组(P<0.05);OLIF组术后3 d时椎间隙高度(disc height,DH)高于MIS-TLIF组(P<0.05),两组术后3个月的DH和术后腰椎前凸角、腰椎滑脱程度比较,差异无统计学意义(P>0.05);OLIF组术后1、3个月JOA评分、ODI指数、VAS评分与MIS-TLIF组比较,差异无统计学意义(P>0.05)。结论两种手术治疗Ⅰ、Ⅱ度单节段DLS均具有明显效果,与MIS-TLIF术比较,OLIF手术具有创伤性小、出血量少、手术时间短以及术后恢复快等优点。Objective To analyze and study the efficacy of oblique lateral interbody fusion(OLIF)and minimally invasive transforminal lumbar interbody fusion(MIS-TLIF)in the treatment of degree I or degree II single-segment degenerative lumbar spondylolisthesis(DLS).Methods A retrospective analysis was performed on the clinical data of 76 patients with degree I or II single-segment DLS.The patients were divided into OLIF group(n=35)and MIS-TLIF group(n=41)according to surgical methods.The intraoperative indicators,postoperative indicators,imaging indicators,pain level before and after surgery and lumbar function were compared between the two groups.Results The incision length,surgical time,ambulation time and hospital stay in OLIF group were shorter than those in MIS-TLIF group,and the intraoperative blood loss and postoperative drainage volume were less than those in MIS-TLIF group(P<0.05).The disc height(DH)in OLIF group was higher than that in MIS-TLIF group at 3 d after surgery(P<0.05).There were no significant differences in the DH at 3 months after surgery and postoperative lumbar lordosis and lumbar spondylolisthesis degree between the two groups(P>0.05).There were no statistically significant differences in the JOA score,ODI index and VAS score at 1 month and 3 months after surgery between the two groups(P>0.05).Conclusion Both two methods have obvious effects in the treatment of degree I and degree II single-segment DLS.Compared with MIS-TLIF,OLIF has advantages of smaller trauma,less blood loss,shorter surgical time and faster postoperative recovery.

关 键 词：斜外侧椎间融合术 小切口经椎间孔椎间融合术 单节段退行性腰椎滑脱 

分 类 号：R687.3[医药卫生—骨科学]