侧前路减压融合术在腰椎间盘突出症伴椎体后缘骨软骨病中的应用及对ODI、椎间隙前、后缘高度的影响分析

Application of lateral-anterior lumbar interbody fusion in the treatment of lumbar disc herniation complicated with vertebral osteochondrosis at the posterior edge and its influence on ODI and the height of the anterior and posterior edges of the intervertebral space

目的探析共病(腰椎间盘突出症(LDH)+椎体后缘骨软骨病(VO))患者应用侧前路减压融合术(LALIF)效果及对Oswestry功能障碍指数(ODI)、椎间隙前、后缘高度的影响。方法选择2020年1月—2021年10月本院收治的80例LDH伴VO患者作为研究对象,根据术式实施差异分为观察组和对照组两组,每组各40例。对照组实施斜外侧椎间融合术(OLIF),观察组实施LALIF。对比两组临床疗效(改良MacNab标准)、术前、术后1周腰椎功能康复(ODI)及疼痛(视觉疼痛模拟评分(VAS))改善情况、椎间隙前后缘高度变化及并发症风险。结果观察组临床疗效优良率、椎间隙前、后缘高度高于对照组,且治疗1周后观察组ODI、VAS评分低于对照组(P<0.05)。两组并发症发生率无统计学差异(P>0.05)。结论LALIF应用于LDH伴VO患者治疗中临床效果显著,彻底去除突出椎间盘及骨化物,促进患者腰椎功能康复,改善疼痛症状及椎间隙前后缘高度,安全性较高,值得临床推广。

Objective To analyze the efficacy of lateral-anterior lumbar interbody fusion(LALIF)on patients with comorbidities(lumbar intervertebral disc herniation(LDH)+vertebral osteochondrosis(VO)at the posterior edge)and the influence on the Oswestry dysfunction index(ODI),the height of the anterior and posterior edges of the intervertebral space.Methods Eighty patients suffered with LDH and VO who were treated in our hospital from January 2020 to October 2021 were selected as study objects,and they were divided into observation group(n=40)and control group(n=40)according to the differences in surgical procedures.Oblique lateral interbody fusion(OLIF)was performed in the control group,and LALIF was performed in the observation group.The clinical efficacy(modified MacNab standard),improvement of lumbar function rehabilitation(ODI)and pain(visual pain analog scale(VAS))before operation and at 1 week after operation,changes in the height of the anterior and posterior edge of the intervertebral space,and the risk of complications were compared between the two groups.Results The distinguished achiever ratio of clinical efficacy,the height of the anterior and posterior margins of the observation group were higher than those of the control group,and the ODI and VAS scores of the observation group were lower than those of the control group at 1 week after treatment(P<0.05).There was no statistical difference in the incidence of complications between the two groups(P>0.05).Conclusions LALIF performs a significant clinical effect in the treatment of patients with LDH and VO.It could completely remove herniated intervertebral discs and ossifications,promote the recovery of the patient’s lumbar spine function,improve pain symptoms and the height of the anterior and posterior edges of the intervertebral space.It has high safety and is worthy of clinical promotion.