斜外侧腰椎体间融合术初次术后邻近节段退变

Oblique lumbar interbody fusion for adjacent segment degeneration secondary to previous lumbar fusion

[目的]评价斜外侧腰椎体间融合术(oblique lumbar interbody fusion,0LIF)治疗腰椎融合术后邻近节段退变的临床效果。[方法]回顾性分析2016年12月一2019年12月本院脊柱外科采用0LIF术治疗腰椎融合术后邻近节段退变50例患者的临床资料。[结果]50例患者均顺利完成手术,均未发生严重并发症。所有患者随访12〜16个月,平均(13.74±1.63)个月。术后(12.66±3.64)周患者恢复完全负重活动。随访期间,患者术后疼痛逐步减缓,功能逐步改善。与术前相比较,末次随访时VAS和0DI评分均显著下降(P<0.05)。影像方面,与术前相比,末次随访时患者的腰椎前凸角(LL)显著增加(P<0.05),而侧凸Cobb角显著减少(P<0.05)。至末次随访时,50例患者再次手术椎间隙均达到骨性融合,椎间融合器无移位、下沉。[结论]采用0LIF治疗腰椎融合术后邻近节段退变具有较好的安全性和有效性。

[Objective]To evaluate the clinical efficacy of oblique lumbar interbody fusion(OLIF)for treatment of adjacent lumbar degeneration secondary to previous lumbar fusion.[Methods]A retrospective study was done on 50 patients who received OLIF for adjacent segment degeneration after primary lumbar fusion in our department from December 2016 to December 2019.[Results]All the 50 patients were successfully operated without serious complications,and were followed up for 12〜16 months,with an average of(13.74±1.63)months.The patient resumed full weight-bearing activity at(12.66±3.64)weeks postoperatively.During the follow-up period,pain gradually relieved,whereas function gradually improved.Both VAS and ODI scores significantly decreased at the last follow-up compared with those before operation(P<0.05).Radiographically,the lumbar lordosis angle(LL)significantly increased(P<0.05),whereas the Cobb angle of scoliosis decreased significantly at the last follow-up compared with those preoperatively(P<0.05).By the time of the latest follow-up,all the 50 patients had bony fusion in the involved segment,without displacement or subsidence of the cage.[Conclusion]The OLIF has good safety and efficacy in the treatment of adjacent segment degeneration after previous lumbar fusion.