斜外侧与微创经椎间孔入路腰椎椎间融合术治疗 布鲁氏菌脊柱炎的疗效对比研究  

Comparative study of efficacy of oblique lateral lumbar interbody fusion(OLIF)with minimally invasive transforaminal approach for brucellosis spondylitis(BS)

作　　者：张斌[1,2] 李世达 张思平 董振宇 张焕文[1,2] 佟敏 王荣 黄异飞[1,2] ZHANG Bin;LI Shida;ZHANG Siping;DONG Zhengyu;ZHANG Huanwen;TONG Min;WANG Rong;HUANG Yifei(The Second Department of Spine,Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University;Xinjiang Uygur Autonomous Region Institute of Traditional Chinese Medicine,Urumqi 830000,China)

机构地区：[1]新疆医科大学附属中医医院脊柱二科 [2]新疆维吾尔自治区中医药研究院,乌鲁木齐830000

出　　处：《新疆医科大学学报》2025年第4期399-405,共7页Journal of Xinjiang Medical University

基　　金：国家自然科学基金项目(81960812);新疆维吾尔自治区科技创新领军人才—高层次领军人才项目(2022TSYCLJ0027);省部共建中亚高发病成因与防治国家重点实验室开放课题-重点项目(SKL-HIDCA-2019-ZY2)。

摘　　要：目的比较斜外侧腰椎椎间融合术(Oblique lateral lumbar interbody fusion,OLIF)与微创经椎间孔入路腰椎椎间融合术(Minimally invasive surgery-transforaminal interbody fusion,MIS-TLIF)治疗布鲁氏菌脊柱炎(Brucella spondylitis,BS)的临床疗效。方法回顾性分析2019年1月-2023年3月新疆医科大学附属中医医院脊柱二科收治的41例BS患者的临床资料,根据手术方法分为OLIF组17例,MIS-TLIF组24例,比较两组围手术期指标、临床疗效、影像学结果以及炎症指标的差异。结果与MIS-TLIF组相比,OLIF组手术时间更短,术中出血量更低,术后3天内VAS评分显著降低,术后腰椎前凸角显著改善,差异有统计学意义(P<0.05)。两组术后视觉模拟评分(Visual analogue scale,VAS)、Oswestry功能障碍指数(Oswestry disbility index,ODI)、术后腰椎前凸角均较术前显著改善(P<0.05)。结论OLIF治疗BS的创伤小、出血少,可以较好的保留腰椎骨性结构,促进腰椎前凸的恢复,且安全性高,值得临床推广和应用。Objective To compare the clinical efficacy of oblique lateral lumbar interbody fusion(OLIF)with minimally invasive surgery-transforaminal interbody fusion(MIS-TLIF)in the treatment of brucellosis spondylitis(BS).Methods The clinical data of 41 BS patients admitted to the hospital from January 2019 to March 2023 were retrospectively analyzed,17 cases in the OLIF group and 24 cases in the MIS-TLIF group,and the differences in perioperative indexes,clinical efficacy,radiographic outcomes and inflammatory indexes between the 2 groups were compared.Results Compared with MIS-TLIF group,the OLIF group had shorter surgery time,lower intraoperative blood loss,significantly reduced VAS scores within 3 days after surgery and significantly improved lumbar lordosis angle after the surgery,with statistical significance(P<0.05).Both groups showed significant improvement in postoperative Visual Analog Scale(VAS),Oswestry Disability Index(ODI)and lumbar lordosis angle compared to preoperative levels(P<0.05).Conclusion OLIF treatment of BS has less traumatic and less bleeding,can better preserve the lumbar bony structure,promote the recovery of lumbar lordosis,and is safe,and worthy of clinical promotion and application.

关 键 词：布鲁氏菌脊柱炎 斜外侧腰椎椎间融合术 微创经椎间孔腰椎椎间融合术 

分 类 号：R681.2[医药卫生—骨科学]