斜外侧腰椎椎体间融合术治疗退变性腰椎滑脱症的疗效

Effect of oblique lateral lumbar interbody fusion on degenerative lumbar spondylolisthesis

目的探讨斜外侧腰椎椎体间融合术(OLIF)治疗退变性腰椎滑脱症的疗效。方法将78例单节段退变性腰椎滑脱症患者按照治疗方法的不同分为OLIF组(31例)和后路腰椎椎体间融合术(PLIF)组(47例)。比较两组手术情况,记录腰椎前凸角、椎间隙高度改善程度,采用JOA评分评估腰椎功能情况,采用ODI评定功能障碍情况。结果手术时间、术中出血量、切口长度OLIF组短(少)于PLIF组(P<0.001)。患者均获得随访,时间9~16个月。腰椎前凸角和椎间隙高度两组术后、末次随访时均较术前明显改善(P<0.05);椎间隙高度术后及末次随访时OLIF组均高于PFIF组(P<0.05)。JOA评分和ODI两组术后、末次随访时均较术前明显改善(P<0.05)。JOA评分术后、末次随访时两组间比较差异均无统计学意义(P>0.05);ODI术后OLIF组优于PLIF组(P<0.05),末次随访时两组间比较差异无统计学意义(P>0.05)。两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论OLIF治疗退变性腰椎滑脱症具有手术切口小、手术时间短、术中出血少、术后恢复快等优点。

Objective To investigate the efficacy of oblique lateral lumbar interbody fusion(OLIF)in the treatment of degenerative lumbar spondylolisthesis.Methods The 78 patients with single-segment degenerative lumbar spondylolisthesis were divided into OLIF group(31 cases)and posterior lumbar interbody fusion(PLIF)group(47 cases).The surgery conditions were compared,and the improvement degree of lumbar lordosis angle and intervertebral space height were recorded.JOA score and ODI were used to evaluate lumbar function and lumbar dysfunction.Results The operation time,intraoperative blood loss and incision length in OLIF group were shorter(less)than those in PLIF group(P<0.001).All patients were followed up for 9~16 months.The lumbar lordosis angle and intervertebral space height of the two groups at the postoperation and last follow-up were significantly improved than the preoperation(P<0.05);the intervetebral space height of the postoperation and last follow-up in OLIF group were higher than those of the PLIF group(P<0.05).JOA score,ODI:at the postoperation and last follow-up,the data of two groups were significantly improved than the preopeation(P<0.05);and JOA score had no difference between two groups at the postoperation and last follow-up(P>0.05);ODI:at the postoperation,OLIF group was better than PLIF group(P<0.05),there was no difference between two groups at the last follow-up(P>0.05).There was no significant difference in the incidence rate of postoperative complications between the two groups(P>0.05).Conclusions OLIF in the treatment of degenerative lumbar spondylolisthesis has the advantages of small incision,shorter operation time,less intraoperative bleeding and faster recovery.