同体位下斜外侧腰椎间融合结合机器人引导经皮内固定术与微创经椎间孔入路腰椎椎体间融合术Ⅰ期治疗单节段腰椎滑脱症的疗效比较  

To compare the efficacy of OLIF combined with robot-guided percutaneous internal fixation and MIS-TLIF in the treatment of single-segment lumbar spondylolisthesis

作　　者：潘学康 陆惠根 戴加平 陈宝 俞叶锋 周晓 PAN Xuekang;LU Huigen;DAI Jiaping;CHEN Bao;YU Yefeng;ZHOU Xiao(Jiaxing Second Hospital,Jiaxing 314000,China)

机构地区：[1]嘉兴市第二医院,浙江嘉兴314000

出　　处：《浙江实用医学》2023年第4期297-302,共6页Zhejiang Practical Medicine

基　　金：浙江省医药卫生科技计划项目(2020RC037)。

摘　　要：目的比较同体位下斜外侧腰椎间融合结合机器人引导经皮后路内固定技术(改良OLIF)与微创经椎间孔入路腰椎椎体间融合术(MIS-TLIF)1期治疗单节段腰椎滑脱症的疗效。方法选择浙江省嘉兴市第二医院2019年1月~2021年12月40例单节段Ⅰ、Ⅱ度腰椎滑脱症患者。随机分为改良OLIF组和MIS-TLIF组,每组20例。改良OLIF组采用斜外侧腰椎间融合结合机器人引导经皮内固定术,MIS-TLIF组采用微创经椎间孔入路腰椎椎体间融合术。随访6~23个月,比较两组手术时间、术中出血量、术后住院时间、VAS评分、JOA评分、螺钉位置评估、临床疗效并回顾经典病例。结果与MIS-TLIF组比较,改良OLIF组术中出血量更少、术后住院时间更短、术后7天腰背部疼痛VAS评分更低,差异均有统计学意义(P<0.01);两组手术时间、术后3个月及末次随访腰部及下肢疼痛VAS评分、JOA评分、置钉准确率及临床疗效差异均无统计学意义(P>0.05)。结论改良OLIF手术治疗腰椎滑脱症具有手术创伤小、术后恢复快、早期症状改善明显等优点,机器人引导下使同体位下OLIF后路置钉更安全、便捷。Objective To explore the difference in the efficacy of one-stage treatment of single segment lumbar spondylolisthesis using the combination of oblique lateral lumbar interbody fusion in the same body position and robot guided percutaneous posterior internal fixation technology(improved OLIF)and minimally invasive lumbar interbody fusion through intervertebral foramen(MIS-TLIF).Method Forty patients with single segment Ⅰ and Ⅱ degree lumbar spondylolisthesis were selected from the Second Hospital of Jiaxing City,Zhejiang Province from January 2019 to December 2021.Randomly divided into an improved OLIF group and a MIS-TLIF group,with 20 cases in each group.Follow up for 6 to 23 months,compare the surgical time,intraoperative bleeding volume,postoperative hospital stay,VAS score,JOA score,screw position evaluation,clinical efficacy,and review classic cases between the two groups.Result Compared with the MIS-TLIF group,the improved OLIF group had fewer intraoperative bleeding,shorter postoperative hospital stay,and lower VAS scores for lower back pain 7 days after surgery,with statistically significant differences(P<0.01);There was no statistically significant difference between the two groups in surgical time,VAS score,JOA score,accuracy of nail placement,and clinical efficacy for lumbar and lower limb pain at 3 months and the last follow-up(P>0.05).Conclusion The improved OLIF surgery for lumbar spondylolisthesis has the advantages of minimal surgical trauma,fast postoperative recovery,and significant improvement in early symptoms.Robot navigation makes the placement of OLIF screws in the same body position safer and more convenient.

关 键 词：腰椎滑脱症 微创手术 斜外侧腰椎间融合术 机器人导航 腰椎椎体间融合术 

分 类 号：R687.3[医药卫生—骨科学]