斜外侧腰椎椎间融合联合侧方钉板内固定治疗腰椎滑脱症

Treatment of lumbar spondylolisthesis by oblique lateral lumbar interbody fusion combined with lateral nail plate internal fixation

目的探讨斜外侧腰椎椎间融合(OLIF)联合侧方钉板内固定术治疗腰椎滑脱症患者的临床疗效。方法回顾性研究2018年11月至2020年3月我院采用OLIF联合侧方钉板内固定术治疗Ⅰ、Ⅱ度腰椎滑脱症患者37例,观测患者末次随访时CT矢状位上融合器有无下沉情况,记录手术时间、术中出血量及术后并发症,采用疼痛视觉模拟评分(VAS)、oswestry功能障碍指数(ODI)评估临床疗效。结果与术前比较,37例患者的术后1、3月、末次随访的VAS、ODI评分均减少,P<0.01;与术后1月比较,术后3月、末次随访的VAS、ODI评分均减少,P<0.05;与术后3月比较,末次随访的VAS、ODI评分减少,P<0.05。结论OLIF联合侧方钉板内固定术可有效撑开椎间隙、增强患椎节段稳定性、防止融合器下沉;该术式安全可靠、术后并发症少。

Objective To explore the clinical curative effect of inclined lateral lumbar intervertebral fusion(oblique lateral interbody fusion,OLIF)joint lateral plate fixation for the treatment of patients with lumbar olisthe disease.Methods A retrospective study was carried out on 37 patientswith lumbar olisthe disease in I or II degrees in our hospital who received OLIF joint lateral nail plate internal fixation treatment.The subsidence of the fusion cage in the CT lesion was observed at the last follow-up.Operative time,intraoperative blood loss and postoperative complications were recorded.Clinical efficacy was assessed by visual analogue Scale(VAS)and Oswestry Disability Index(ODI).Results Compared with preoperation,the VAS and ODI scores of 37 patients decreased at 1,3 months after operation and the last follow-up,P<0.01;Compared with 1 month after surgery,VAS and ODI scores were decreased at 3 months after surgery and at the last follow-up,P<0.05;Compared with 3 months after operation,the VAS and ODI scores in the last follow-up were decreased,P<0.05.Conclusion OLIF combined with lateral nail plate internal fixation can effectively open the vertebral space,enhance the stability of affected vertebral segment and prevent the fusion cage from sinking.The operation is safe and reliable with few postoperative complications.