O型臂导航在微创经椎间孔腰椎椎间融合术治疗退行性腰椎滑脱症中的应用  

Application of O-arm Navigation in Minimally Invasive Transforaminal Lumbar Interbody Fusion for Degenerative Lumbar Spondylolisthesis

作　　者：陈胤 杨磊[1] 徐峰 CHEN Yin;YANG Lei;XU Feng(School of Medicine,Wuhan University of Science and Technology,Wuhan Hubei 430065,China)

机构地区：[1]武汉科技大学医学部医学院,湖北武汉430065 [2]中部战区总医院骨科

出　　处：《联勤军事医学》2024年第4期297-303,共7页Military Medicine of Joint Logistics

基　　金：武汉市应用基础前沿项目(2019020701011423)。

摘　　要：目的 比较O型臂导航辅助微创经椎间孔腰椎椎间融合术(minimally invasive transforaminal lumbar interbody fusion, MIS-TLIF)与C型臂辅助MIS-TLIF治疗退行性腰椎滑脱症的临床疗效。方法 对2022-06/2023-06月42例在作者医院行O型臂辅助或C型臂辅助MIS-TLIF治疗单节段退行性腰椎滑脱症患者的资料进行分析。依据手术类型将患者分为O型臂辅助MIS-TLIF组(n=20)和C型臂辅助MIS-TLIF组(n=22),O型臂辅助MIS-TLIF组患者接受O型臂辅助MIS-TLIF治疗,C型臂辅助MIS-TLIF组患者接受C型臂辅助MIS-TLIF治疗。比较两组退行性腰椎滑脱症患者人口统计学变量、围手术期指标、背部与腿部疼痛视觉模拟量表(visual analogu scale, VAS)评分、Oswestry残疾指数(Oswestry disability index, ODI)及临床结局。结果 O型臂辅助MIS-TLIF组患者术中出血量、术后引流量显著低于C型臂辅助MIS-TLIF组,差异有统计学意义(P均<0.05)。O型臂辅助MIS-TLIF组退行性腰椎滑脱症患者的置钉准确率明显高于C型臂辅助MIS-TLIF组,差异有统计学意义(P<0.05)。两组退行性腰椎滑脱症患者背痛VAS评分、ODI评分随时间不断降低(P均<0.05)。同一时间点比较,术前两组退行性腰椎滑脱症患者背痛VAS评分、ODI评分比较差异无统计学意义(P>0.05),术后1周与术后3个月,O型臂辅助MIS-TLIF组退行性腰椎滑脱症患者背痛VAS评分、ODI评分低于C型臂辅助MIS-TLIF组(P均<0.05),其余时间点两组退行性腰椎滑脱症患者背痛VAS评分、ODI评分差异无统计学意义(P>0.05)。两组退行性腰椎滑脱症患者腿痛VAS评分随时间不断降低(P均<0.05)。两组退行性腰椎滑脱症患者各时间点腿痛VAS评分比较差异无统计学意义(P>0.05)。O型臂辅助MIS-TLIF组、C型臂辅助MIS-TLIF组退行性腰椎滑脱症Odom标准总体优良率分别为85.00%、 90.91%,二者比较差异无统计学意义(P>0.05)。两组退行性腰椎滑脱症患者在术后12个月复查时均无融合失Objective To compare the clinical outcomes of O-arm navigation assisted minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF) and C-arm assisted MIS-TLIF in the treatment of degenerative lumbar spondylolisthesis.Methods Data of 42 patients with single-segment degenerative lumbar spondylolisthesis who underwent O-arm-assisted or C-arm-assisted MIS-TLIF in author′s hospital were analyzed from June 2022 to June 2023. The patients were divided into O-arm-assisted MIS-TLIF group(n=20) and C-arm-assisted MIS-TLIF group(n=22) according to the type of surgery. Patients in the O-arm-assisted MIS-TLIF group were treated with O-arm-assisted MIS-TLIF, and the patients in the C-arm-assisted MIS-TLIF group were treated with C-arm-assisted MIS-TLIF. Demographic variables, perioperative indicators, visual analogu scale(VAS) score of back and leg pain, Oswestry disability index(ODI)and clinical outcomes of patients with degenerative lumbar spondylolisthesis between two groups were evaluated and compared.Results The intraoperative blood loss and postoperative drainage volume in the O-arm-assisted MIS-TLIF group were significantly lower than those in the C-arm-assisted MIS-TLIF group, and the differences were statistically significant(all P<0.05). The accuracy of screw placement of patients with degenerative lumbar spondylolisthesis in the O-arm-assisted MIS-TLIF group was significantly higher than that in the C-arm-assisted MIS-TLIF group and the differences were statistically significant(P<0.05). The VAS score of back pain and ODI score of patients with degenerative lumbar spondylolisthesis in two groups decreased by time(all P<0.05).There was no significant difference in VAS score of back pain and ODI score of patients with degenerative lumbar spondylolisthesis between the two groups before surgery at the same timing(P>0.05), at 1 week and 3 months after surgery, VAS score of back pain and ODI score of patients with degenerative lumbar spondylolisthesis in the O-arm-assisted MIS-TLIF group were lower than those i

关 键 词：O型臂导航 微创经椎间孔腰椎椎间融合术 退行性腰椎滑脱症 脊柱退行性疾病 

分 类 号：R687.3[医药卫生—骨科学]