O/XLIF治疗腰椎退变性滑脱疗效观察

Effects of O/XLIF in the treatment of lumbar degenerative spondylolisthesis

目的观察O/XLIF技术治疗退变性腰椎滑脱临床疗效。方法回顾性分析2018年9月-2020年3月在潍坊市中医院脊柱外科就诊并符合标准患者81例。其中O/XLIF组23例,TLIF组58例。观察两组患者手术时间、出血量、术后引流量、住院时间、手术相关并发症以及手术前后VAS评分、ODI评分、腰椎曲度、椎间隙高度、硬膜囊横截面积。结果所有患者均顺利完成手术,无神经血管损伤。术前腰痛、下肢痛麻等症状明显改善。O/XLIF组手术时间、出血量、引流量、平均住院时间均少于TLIF组。术后出现发热及腰腿疼痛等症状明显较TLIF组少。术后3d、3月的VAS评分、ODI指数O/XLIF组优于TLIF组,但末次随访两组间差异无统计学意义。椎间隙高度及腰椎前凸恢复O/XLIF组均优于TLIF组。TLIF组硬膜囊横截面积恢复优于O/XLIF组。结论对于腰椎退变性滑脱的治疗O/XLIF较TLIF创伤更小,恢复更快,并发症更少,更有利于椎间隙高度的恢复和生理前凸的恢复。

Objective To observe the clinical efficacy of O/XLIF in the treatment of degenerative lumbar spondylolisthesis.Methods From September 2018 to March 2020,81 patients who met the standard in the spine surgery department of Weifang Hospital of Traditional Chinese Medicine were collected and data were analyzed.There were 23 cases in the O/XLIF group and 58 cases in the TLIF group.The operative time,amount of blood loss,drainage volume,hospitalization time,operation-related complications,VAS score,ODI score,lumbar curvature,intervertebral height and cross-sectional area(CSA)of the dural sac before and after surgery were observed in two groups.Results All patients completed the operation successfully without neurovascular injury.The symptoms of back pain,lower limb pain and numbness were significantly improved before operation.Operation time,blood loss,drainage volume and average length of hospital stay in the O/XLIF group were all lower than those in the TLIF group.The postoperative symptoms of fever and lumbar and/or leg pain were significantly less than those in the TLIF group.The VAS score and ODI indexesat 3 days and 3 months after surgery in the O/XLIF group were superior to those in the TLIF group,but the difference between the two groups at the last follow-up was not statistically significant.The recovery of intervertebral height and lumbar lordosis in O/XLIF group was better than that in TLIF group.The recovery of cross-sectional area of dural sac in TLIF group was better than that in O/XLIF group.Conclusion Compared with TLIF,O/XLIF in the treatment of lumbar degenerative spondylolisthesis has less trauma,faster recovery and fewer complications,which is more conducive to therecovery of the height of intervertebral space and lumbar lordosis.