OLIF手术治疗退行性脊柱畸形疗效观察  

The Clinical Efficacyof Oblique Lateral Interbody Fusion in the Treatment of Adult Degenerative Scoliosis

作　　者：万宣 李勇[1] 徐王兵[1] 周荣平[2] 曹凯[2] WAN Xuan;LI Yong;XU Wang-bing;ZHOU Rong-ping;CAO Kai(The Affiliated Hospital of Jiangxi University of Chinese Medicine,Nanchang 330006,China;The First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]江西中医药大学附属医院,南昌330006 [2]南昌大学第一附属医院,南昌330006

出　　处：《江西中医药大学学报》2022年第5期35-38,共4页Journal of Jiangxi University of Chinese Medicine

基　　金：江西省卫生健康委员会科技计划项目(20191029)。

摘　　要：目的:观察斜外侧腰椎椎间融合术(OLIF)治疗退行性脊柱侧弯(ADS)的临床疗效。方法:选取2017年3月-2020年12月于南昌大学第一附属医院行手术治疗的退行性脊柱侧弯患者61例,根据手术方式分为传统后路组与OLIF组。比较两组患者术中出血量、手术时长、术后下床时间以及手术前后的视觉模拟评分(VAS)、功能障碍指数(ODI)、腰椎冠状位Cobb角、整体冠状位平衡(GCB)、腰椎前凸角(LL)、骶骨倾斜角(SS)、骨盆倾斜角(PT)、骨盆入射角(PI)、矢状面垂直轴偏距(SVA)等,讨论OLIF手术与传统后路手术的疗效差异。结果:OLIF组与传统后路组相比,出血量更少(P<0.05)、下床活动时间更短(P<0.05)。两组患者手术时间比较无显著差异(P>0.05)。两组VAS、ODI评分比较,术前差异无统计学意义(P>0.05),术后OLIF组比传统后路组更低,差异有统计学意义(P<0.05)。两组手术前后冠状位Cobb角、LL、SS、PT、PI比较差异无统计学意义(P>0.05),两组术后SVA值均较术前显著降低(P<0.05)。OLIF组术后GCB较传统后路组更小(P<0.05)。结论:在退行性脊柱侧弯治疗中,OLIF手术相比传统后路手术创伤小,在术后早期疼痛和功能改善方面有其一定优势,值得进一步研究及推广。Objective:To observe the clinical effect of Oblique Lateral Interbody Fusion(OLIF)in treating Adult Degenerative Scoliosis(ADS).Methods:61 patients with ADS who were surgically treated in our hospital between March 2017 and December 2020 were included in this study.29 patients were treated with OLIF and 32 patients were treated with traditional posterior approach.The data ofblood loss,operation time,the time of getting out of bed,as well as the Visual Analogue Scale(VAS),Oswestry Disability Index(ODI),coronal lumbar Cobb angle,global coronal balance(GCB),lumbar lordosis(LL),pelvic incident(PI),pelvic tilt(PT),Sacral Slope(SS)and sagittal vertical axis(SVA)were reviewed.Results:The blood loss and the time of getting out of bed in OLIF group were less than posterior group(P<0.05).There was no significant difference of operation time between the two groups(P>0.05).The postoperative VAS and ODI of OLIF group were lower than that of posterior group(P<0.05).There was no significant difference in sagittal parameters between the two groups(P>0.05).Postoperative GCB of OLIF group was significantly lower than that in posterior group.Postoperative SVA of OLIF group was significantly lower than that in posterior group(P<0.05).There was no significant difference in LL,SS,PT,PI between the two groups(P>0.05).Conclusion:Compared with traditional surgery,OLIF has certain advantages in improvement of function recovery and pain,which is worth to be popularized.

关 键 词：退变性脊柱侧弯 斜外侧腰椎椎间融合术 传统后路手术 脊柱平衡 

分 类 号：R274.9[医药卫生—中西医结合]