自锚式斜外侧腰椎椎间融合术与前路融合联合后路经皮椎弓根钉内固定术治疗布鲁氏菌性脊柱炎的短期疗效比较  

Short-term efficacy of oblique lumbar interbody fusion with self-anchored fusion cage compared with anterior fusion combined with posterior percutaneous pedicle screw fixation for primary treatment of brucella spondylitis

作　　者：沙西卡·那孜尔汗 郭瑞[1] 张树文 李坤[1] 孙治国[1] 王浩[1] Shaxika Nazierhan;GUO Rui;ZHANG Shuwen;LI Kun;SUN Zhiguo;WANG Hao(Department of Spinal Surgery,Center of Orthopaedics,People's Hospital of Xinjiang Uygur Autonomous Region,Uygur 830000,China)

机构地区：[1]新疆维吾尔自治区人民医院骨科中心脊柱二科,乌鲁木齐830000

出　　处：《中华骨与关节外科杂志》2023年第4期355-360,共6页Chinese Journal of Bone and Joint Surgery

基　　金：新疆维吾尔自治区自然科学基金(2018D01C135)。

摘　　要：目的:比较自锚式斜外侧腰椎椎间融合术(OLIF)与前路融合联合后路经皮椎弓根钉内固定术一期治疗布鲁氏菌性脊柱炎(LBS)的短期临床疗效。方法:选择2010年6月至2020年6月收治的37例腰椎LBS患者进行回顾性分析。传统手术组21例患者接受一期前路清创、融合联合后路经皮椎弓根钉内固定术,OLIF组16例患者接受一期单纯OLIF病灶清除、自锚式融合器植入。比较两组患者手术时间、术中出血量、住院时间、骨融合时间、疼痛视觉模拟评分(VAS)、畸形矫正情况等。结果:所有患者均顺利完成手术且腰椎LBS均治愈。传统手术组平均随访(24.8±7.8)个月,OLIF组平均随访(23.5±7.3)个月。OLIF组患者手术时间和术中出血量均优于传统手术组患者,且差异均有统计学意义(P<0.05)。两组患者住院时间、骨融合时间和末次随访时VAS评分差异均无统计学意义(P>0.05)。末次随访时,OLIF组患者cobb角大于传统手术组患者,且差异有统计学意义(P=0.046)。结论:与前路融合联合后路经皮椎弓根钉内固定术相比,自锚式OLIF治疗腰椎LBS的临床和影像学结果更好,具有切口较小、出血较少和早期康复的优势,但对骨质情况需要进一步评估。Objective:To compare the short-term clinical efficacy of single oblique lumbar interbody fusion(OLIF)with selfanchored fusion cage and anterior fusion combined with posterior percutaneous pedicle screw internal fixation in the primary treatment of brucella spondylitis(LBS).Methods:A retrospective analysis was conducted on 37 patients with lumbar LBS admitted from June 2010 to June 2020.The traditional group of 21 patients underwent one-stage anterior debridement,fusion,and posterior percutaneous pedicle fixation,while the OLIF group of 16 patients underwent one-stage simple OLIF lesion clearance and self-anchored fusion cage implantation.Compare the clinical and surgical results of two groups of patients in terms of surgical time,intraoperative bleeding,hospital stay,bone fusion time,visual analogue scale of pain,and deformity correction.Results:All patients successfully completed the surgery and lumbar LBS was cured.The follow-up time was(24.8±7.8)months in the traditional group and(23.5±7.3)months in the OLIF group.The surgical time and intraoperative bleeding volume in the OLIF group were better than those in the traditional group(P<0.05).There was no statistically significant difference in hospital stay,bone fusion time,and VAS score at the last follow-up between the two groups(P>0.05).At the last follow-up,the Cobb angle in the OLIF group was higher than that in the traditional group(P=0.046).Conclusions:The anterior self anchored fusion cage provides better clinical and imaging results than the anterior fusion combined with percutaneous pedicle screw fixation as smaller incision,less bleeding and early recovery,but the bone condition needs further evaluation.

关 键 词：腰椎 布鲁氏菌性脊柱炎 斜外侧腰椎椎间融合术 自锚式融合器 

分 类 号：R516.7[医药卫生—内科学] R681.5[医药卫生—临床医学]