斜外侧椎间融合术治疗老年腰椎结核患者的临床评价

Clinical Evaluation of Oblique Lateral Interbody Fusion in the Treatment of Elderly Patients with Lumbar Tuberculosis

目的:对比斜外侧椎间融合术(OLIF)与后路腰椎椎体间融合术(PLIF)治疗老年腰椎结核患者的短期临床疗效。方法:回顾性分析2019年10月至2021年1月昆明市第三人民医院骨科手术治疗的以椎间隙病变为主的腰椎结核患者42例的病例资料,按手术方式分为OLIF组(n=15)和PLIF组(n=27),比较两组患者的手术时间、术中出血量、术后下床活动时间、并发症发生情况等。结果:两组患者手术时间、并发症发生率差异无统计学意义(P>0.05)。OLIF组术中出血量、术后下床活动时间等指标均优于PLIF组,差异有统计学意义(P<0.05)。至末次随访时,所有患者均未发现结核复发迹象,均未出现内固定装置障碍。结论:OLIF治疗以椎间隙破坏为主的腰椎结核的短期效果是安全有效的,与传统PLIF相比,其术中出血量少、术后疼痛轻、创伤小,不增加手术时间和并发症发生率,符合加速康复的要求。聚醚醚酮材料是否能安全用于治疗脊柱结核仍需进一步观察研究。

Objective:To compare the short-term clinical effects of oblique lateral interbody fusion(OLIF)and posterior lumbar interbody fusion(PLIF)in the treatment of elderly patients with lumbar tuberculosis. Methods:A retrospective analysis of the case data of 42 patients with lumbar tuberculosis with intervertebral space lesions treated by orthopedic surgery in The Third People’s Hospital of Kunming from October 2019 to January 2021.According to surgical methods,they were divided into OLIF group(n=15)and PLIF group(n=27).The operation time,intraoperative blood loss,postoperative out-of-bed activity time,and complications were compared between the two groups. Results:There were no significant differences in operation time and complication rate between the two groups(P>0.05).The OLIF group had better blood loss during operation and postoperative out-of-bad activity time than the PLIF group,and the differences were statistically significant(P<0.05).At the last follow-up,no signs of tuberculosis recurrence were found in all patients,and no internal fixation device obstruction was found. Conclusion:The short-term effect of OLIF in the treatment of lumbar tuberculosis mainly with intervertebral space destruction is safe and effective. Compared with traditional PLIF,it has less intraoperative blood loss,less postoperative pain,less trauma,does not increase the operation time and complication rate,and meets the requirements of rapid recovery. Whether polyetheretherketone materials can be used safely in the treatment of spinal tuberculosis still needs further observation and research.