腰椎斜前侧椎间融合术治疗腰椎退变性疾病效果分析

An Analysis of the Therapeutic Effect of Oblique Lateral Interbody Fusion for Lumbar Degeneration Disease

目的:探讨腰椎斜前侧微创椎间融合术(oblique lateral interbody fusion,OLIF)治疗腰椎间盘退行性疾病的临床效果,为临床治疗提供指导。方法:选取2018年1月-2020年1月中国人民解放军联勤保障队第900医院骨科收治的40例行OLIF手术的腰椎退变性改变的患者资料,比较手术前后椎间盘前缘高度和后缘高度、椎间孔高度、视觉模拟评分(VAS)和日本骨科学会(JOA)评分,统计分析手术的时间、术中出血量、住院时间及术后并发症情况。结果:术后患者腰痛和腿痛症状均明显缓解,无严重并发症发生,末次随访时手术节段均获骨性融合。术后椎间盘前缘高度、后缘高度、椎间孔高度较术前明显增加,差异有统计学意义(P<0.05)。与术前相比,术后腰痛及腿痛VAS及JOA均优,差异有统计学意义(P<0.05)。结论:OLIF微创手术治疗腰椎间盘退变性疾病,其优点有融合率高、严重并发症少、相关影像学数值明显改善,患者腰腿麻痛症状也得到了明显缓解,生活质量大大提高。

Objective:To explore the clinical effect of lumbar oblique anterior interbody fusion (OLIF) in the treatment of degenerative diseases of lumbar disc,and to provide guidance for clinical treatment.Method:From January 2018 to January 2020,the data of 40 patients with lumbar degenerative changes who were treated in the department of Orthopaedics of the 900th Hospital of Joint Logistic Support Force,PLA were collected and compared before and after the operation,including the anterior disc height,posterior disc height,intervertebral foramen height,visual analogue scale (VAS) and Japanese Orthopedic Association (JOA).The operation time,intraoperative blood loss,length of hospital stay and postoperative complications were analyzed.Result:The symptoms of low back pain and leg pain were alleviated,no serious complications occurred,and bone fusion was achieved at the last follow-up.The height of anterior edge,posterior edge and intervertebral foramen increased significantly after operation,and the differences were statistically significant (P<0.05).There were significant differences in VAS and JOA between patients with lumbago and leg pain (P<0.05).Conclusion:The advantages of minimally invasive surgery with OLIF in the treatment of degenerative diseases of lumbar intervertebral disc has high fusion rate,less serious complications,significant improvement of related imaging values,significant relief of numbness and pain in the waist and legs,and greatly improved quality of life.