斜外侧椎间融合术联合侧板固定治疗单节段腰椎退行性疾病疗效分析  

Clinical Efficacy of Oblique Lateral Interbody Fusion Combined with Lateral Plate Fixation in the Therapy of Single-segment Lumbar Degenerative Disease

作　　者：江超 程维[2] 张义强 袁俊龙 JIANG Chao;CHENG Wei;ZHANG Yiqiang;YUAN Junlong(School of Clinical Medicine,Beihua University,Jilin 132013,China;Affiliated Hospital of Beihua University,Jilin 132011,China)

机构地区：[1]北华大学临床医学院,吉林吉林132013 [2]北华大学附属医院,吉林吉林132011

出　　处：《北华大学学报（自然科学版）》2023年第5期640-644,共5页Journal of Beihua University（Natural Science）

基　　金：吉林省卫生健康科技能力提升项目(2021LCO83)。

摘　　要：目的探讨斜外侧椎间融合术联合侧板固定(OLIF combined with lateral plate fixation,OLIF-LPF)治疗单节段腰椎退行性疾病的近期临床疗效.方法回顾性分析行OLIF-LPF治疗单节段腰椎退行性疾病的41例患者临床资料,记录手术时间、手术出血量、术中及术后并发症,比较术前、术后各时间点随访时腰腿痛VAS评分、Oswestry功能障碍指数(ODI);在X线片上测量手术节段腰椎前凸角(lumbar lordosis,LL)、椎间孔高度(foramen height,FH)、椎间隙高度(disc height,DH),通过MRI测量硬膜囊横截面积,通过CT评估椎间融合情况.结果41例患者均获得12个月以上的随访.手术时间为(95.98±22.61)min,术中出血量50~160 mL,平均(81.88±25.15)mL.41例患者术后各时间点随访时ODI、腰腿痛VAS评分均较术前显著好转(P<0.05).手术节段硬膜囊横截面积、FH、DH及LL均较术前显著好转(P<0.05).术后各时间点比较差异无统计学意义(P>0.05).术后12个月随访时所有患者椎间均达到骨性融合.随访过程中未出现腹膜及输尿管损伤情况,无下肢运动障碍、切口感染等并发症.结论OLIF-LPF治疗单节段腰椎退行性疾病的近期疗效确切,手术创伤小,并发症少,能有效恢复椎间隙高度,维持脊柱稳定性.Objective To explore the short-term clinical effect of oblique lateral interbody fusion(OLIF)combined with lateral plate fixation(OLIF-LPF)in the therapy of single-segment lumbar degenerative disease.Method Retrospective analysis of 41 patients who underwent OLIF-LPF for lumbar degenerative disease.The operative time,intraoperative blood loss and postoperative complications were recorded,and VAS scores of low back and leg pain,Oswestry disability index(ODI)were compared at different time points before and after operation.The foraminal height(FH),disc height(DH)and lumbar lordosis(LL)of the operational segment were measured on X-ray images at different time points before operation.The cross-sectional area of dural sac were measured on MRI images,and intervertebral fusion was evaluated by CT scan.Results The average operative time was(95.98±22.61)min and average intraoperative blood loss was 50~160 mL(81.88±25.15)mL.VAS scores and ODI at different time points improved greatly than those before operation(P<0.05).FH,DH,LL,crosssectional area of dural sac at different time points after operation improved significantly comparing with those before operation(P<0.05).There was no statistically significant difference in the comparison of the postoperative time points.All patients achieved bony fusion between the vertebrae at the 12-month postoperative follow-up.No peritoneal or ureteral injury occurred during the follow-up period,and there were no complications such as lower limb motility disorder and incision infection.Conclusion The recent efficacy of OLIF-LPF in the therapy of single-segment lumbar degenerative diseases is precise,with little surgical trauma,few complications,effective restoration of intervertebral space height and satisfactory postoperative recovery.

关 键 词：腰椎退变性疾病 斜外侧椎管融合术 侧板固定 微创 联合手术 

分 类 号：R681.5[医药卫生—骨科学]