后路腰椎椎间融合术与斜外侧腰椎椎间融合术治疗退行性腰椎疾病的临床疗效

Clinical efficacy of posterior lumbar interbody fusion and oblique lateral lumbar interbody fusion in the treatment of degenerative lumbar diseases

目的探究后路腰椎椎间融合术(PLIF)与斜外侧腰椎椎间融合术(OLIF)治疗退行性腰椎疾病的临床疗效。方法回顾性分析2017年1月~2019年9月本院96例行手术治疗的退行性腰椎疾病患者的临床资料,其中44例行PLIF术治疗(PLIF组),52例行OLIF术治疗(OLIF组)。记录两组围术期相关指标、融合率及术后近期并发症发生情况,并比较两组术前、术后1周、术后12周的疼痛视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI),以及术后1周、术后12周椎间隙及椎间孔高度增加情况差异。结果96例患者均行术后24周随访。两组手术时间、融合率及术后并发症发生情况比较,差异无统计学意义(P>0.05);OLIF组术中出血量、术后下床时间均低于PLIF组(P<0.05)。两组组内围术期VAS评分、ODI指数比较,均为术前高于术后1周及术后12周(P<0.05),术后1周高于术后12周(P<0.05);术前及术后12周时,两组组间VAS评分、ODI指数比较,差异均无统计学意义(P>0.05);术后1周时,OLIF组VAS评分、ODI指数均低于PLIF组(P<0.05)。OLIF组术后1周及术后12周椎间隙、椎间孔高度增加值均大于PLIF组(P<0.05)。结论OLIF术及PLIF术均能治疗退行性腰椎疾病,但OLIF术后恢复更快,对单节段退行性腰椎疾病安全、有效。

Objective To explore the clinical efficacy of posterior lumbar interbody fusion(PLIF)and oblique lateral lumbar interbody fusion(OLIF)in the treatment of degenerative lumbar diseases.Methods Retrospective analysis was performed on clinical data of 96 patients with degenerative lumbar diseases who underwent surgical treatment in our hospital from January 2017 to September 2019.A total of 44 patients were treated with PLIF surgery(PLIF group)and 52 patients were treated with OLIF surgery(OLIF group).Perioperative related indicators,fusion rate and occurrence of postoperative short-term complications were recorded in the two groups.Visual analogue score(VAS)and Oswestry disability index(ODI)before surgery and at 1 week and 12 weeks after surgery,and increases of intervertebral space and foraminal height at 1 week and 12 weeks after surgery were compared between the two groups.Results All 96 patients were followed up for 24 weeks after surgery.There were no significant differences in the operation time,fusion rate and occurrence of postoperative complications between the two groups(P>0.05).The intraoperative blood loss,postoperative ambulation time in OLIF group were lower than those in PLIF group(P<0.05).The perioperative VAS score and ODI index in the two groups before surgery were higher than those at 1 week after surgery and at 12 weeks after surgery(P<0.05),and the above indexes at 1 week after surgery were higher than those at 12 weeks after surgery(P<0.05).Before surgery and at 12 weeks after surgery,there were no significant differences in the VAS score and ODI index between the two groups(P>0.05).At 1 week after surgery,the VAS score and ODI index in OLIF group were lower than those in PLIF group(P<0.05).The increases of intervertebral space and foraminal height in OLIF group at 1 week and 12 weeks after surgery were greater than those in PLIF group(P<0.05).Conclusion Both OLIF surgery and PLIF surgery can treat degenerative lumbar diseases,but OLIF has faster postoperative recovery and it is safe and effective for single-segment degenerative lumbar diseases.