斜外侧腰椎椎间融合术联合椎体骨水泥强化术治疗骨量减少腰椎椎管狭窄症  

Oblique Lumbar Interbody Fusion Combined with Vertebral Cement Reinforcement in the Treatment of Lumbar Spinal Stenosis with Bone Loss

作　　者：吴时桢 施宇仪 吴世震 李竞杰 叶宇慧 谢添 WU Shizhen;SHI Yuyi;WU Shizhen;LI Jingjie;YE Yuhui;XIE Tian(College of Acupuncture and Orthopedic,Hubei University of Chinese Medicine,Wuhan 430061,China;National Hospital of Traditional Chinese Medicine/Wuhan Hospital of Traditional Chinese Medicine,Hubei University of Chinese Medicine,Wuhan 430014,China)

机构地区：[1]湖北中医药大学针灸骨伤学院,武汉430061 [2]湖北中医药大学附属国医医院/武汉市中医医院

出　　处：《中国中医骨伤科杂志》2025年第2期76-80,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：湖北省中医药管理局中医药科研重点项目(ZY2023Z011)。

摘　　要：目的:探讨斜外侧腰椎椎间融合术(OLIF)联合椎体骨水泥强化术治疗骨量减少腰椎椎管狭窄症的临床疗效。方法:2022年9月至2024年1月收治骨量减少腰椎椎管狭窄症患者21例,采用斜外侧腰椎椎间融合术联合椎体骨水泥强化术治疗。观察记录手术时间、术中出血量;观察比较术前、术后3 d及3个月的腰痛疼痛视觉模拟量表(VAS)评分、腰椎Oswestry功能障碍指数(ODI)及椎间隙高度(DH),评价临床疗效。结果:21例患者均顺利完成手术,平均手术时间为(87.33±4.86)min,术中出血量为(51.09±6.76)mL。所有患者术后3d及3个月腰痛VAS评分和ODI评分较术前均显著改善,差异有统计学意义(P<0.05),且术后3个月较术后3 d腰痛VAS评分及ODI评分明显改善,差异有统计学意义(P<0.05);术后3 d及3个月椎间隙高度均较术前明显改善,差异有统计学意义(P<0.05),术后3个月椎间隙高度较术后3 d差异无统计学意义(P>0.05)。所有患者未发生螺钉松动、椎体不融合等不良事件。结论:斜外侧腰椎椎间融合术联合椎体骨水泥强化术治疗骨量减少腰椎椎管狭窄症临床效果确切,但有一定学习曲线。Objective:To investigate the clinical efficacy of oblique lumbar interbody fusion(OLIF)combined with vertebral cement reinforcement in the treatment of lumbar spinal stenosis with bone loss.Methods:From September 2022 to January 2024,21 patients of lumbar spinal stenosis with bone loss were treated with OLIF combined with vertebral cement reinforcement surgery.The surgical time and intraoperative blood loss were observed and recorded;the visual analogue scale(VAS)scores,Oswestry disability index(ODI)scores,and disc height(DH)of lower back pain were observed and compared before surgery,3 d after surgery,and 3 months after surgery to evaluate clinical efficacy.Results:All 21 patients successfully completed the surgery,with an average operation time of(87.33±4.86)min and intraoperative blood loss of(51.09±6.76)mL.All patients showed significant improvement in VAS scores and ODI scores for lower back pain at 3 d and 3 months after surgery compared to preoperative levels(P<0.05),and there was a significant improvement in VAS scores and ODI scores for lower back pain at 3 months after surgery compared to postoperative levels(P<0.05).The DH at 3 d and 3 months after surgery also improved significantly compared to preoperative levels(P<0.05),but there was no statistically significant difference in DH at 3 months after surgery compared to postoperative levels(P>0.05).All patients did not experience adverse events such as screw loosening or vertebral body non fusion.Conclusion:OLIF combined with vertebral cement reinforcement surgery has a definite clinical effect on the treatment of lumbar spinal stenosis with bone loss,but it has a certain learning curve.

关 键 词：斜外侧腰椎椎间融合术 骨量减少 腰椎椎管狭窄症 骨水泥 脊柱微创手术 

分 类 号：R681.5[医药卫生—骨科学]