漂浮体位下手术对腰椎退变性疾病患者的影响

Effect of Floating Posture Surgery on Patients with Lumbar Degenerative Diseases Treated with Floating Position Surgery

目的:探究漂浮体位下斜外侧腰椎椎体间融合术(OLIF)联合经皮椎弓根钉技术对腰椎退变性疾病患者的影响。方法:选择丰城市人民医院2019年1月-2021年1月就诊的60例腰椎退变性疾病患者,按照随机数字表法将其分为观察组与对照组,各30例。观察组行漂浮体位下OLIF联合经皮椎弓根钉技术治疗,对照组行传统体位OLIF联合经皮椎弓根钉技术治疗。观察两组住院费用、住院时间、手术时间、术中出血量、体位摆放耗时、椎间融合及术后并发症发生情况,并比较两组术前、术后炎症因子[肿瘤坏死因子-α(TNF-α)、白介素-10(IL-10)、白介素-6(IL-6)]、疼痛程度(VAS评分)、功能障碍(ODI评分)及生活质量评分(SF-36评分)。结果:两组住院费用、住院时间、术中出血量对比,差异均无统计学意义(P>0.05);观察组手术时间、体位摆放耗时均比对照组短(P<0.05);两组术后1 d的TNF-α、IL-10、IL-6均比术前高,但观察组均比对照组低(P<0.05);两组术后6个月VAS评分、ODI评分均比术前低(P<0.05);观察组1、2级椎间融合率为86.67%,比对照组的63.33%高(P<0.05);两组术后6个月SF-36各维度评分均比术前高,且观察组生理职能、精力、生理机能及总体健康维度评分均比对照组高(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:漂浮体位下OLIF联合经皮椎弓根钉技术治疗腰椎退变性疾病安全可靠,对患者术后炎症因子影响较小,可明显缩短其手术时间,促进术后生活质量恢复。

Objective:To explore patients with lumbar degenerative diseases treated with oblique lumbar interbody fusion (OLIF) combined with percutaneous pedicle screw technique under floating position.Method:Sixty patients with lumbar degenerative disease treated in the Fengcheng People’s Hospital from January 2019 and January 2021 were selected.They were divided into observation group and control group by random number table method,30 cases in each group.Patients in the observation group were treated with OLIF combined with percutaneous pedicle screw technique under floating position,while patients in the control group were treated with OLIF combined with percutaneous pedicle screw technique under conventional position.The two groups were compared on hospitalization expenses,length of hospital stay,operation time,intraoperative blood loss,duration of position determination,interbody fusion,postoperative complications,inflammatory factors[tumor necrosis factor-α (TNF-α),interleukin-10 (IL-10),interleukin-6 (IL-6)],pain degree (VAS score),dysfunction (ODI score) and quality of life score (SF-36 score) before and after operation.Result:Hospitalization expenses,length of hospital stay and intraoperative blood loss of the two groups were no significant differences (P>0.05).The operation time and duration of position determination in observation group were shorter than those in control group (P<0.05).The levels of TNF-α,IL-10 and IL-6 were higher in the two groups at 1 d after operation than those before operation,but the levels of TNF-α,IL-10 and IL-6 in the observation group were lower than those in the control group (P<0.05).6 months after operation,the VAS scores and ODI scores of the two groups were lower than those before operation (P<0.05).The level 1 and level 2 interbody fusion rate in the observation group was 86.67% higher than 63.33% in the control group (P<0.05).6 months after operation,the SF-36 scores of the two groups were higher than those before operation,and the scores of physiological function,energy,physiological function and overall health in the observation group were higher than those in the control group (P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05).Conclusion:OLIF combined with percutaneous pedicle screw technique under floating position is safe and reliable in the treatment of lumbar degenerative diseases,which has little influence on inflammatory factors,and can significantly shorten the operation time and promote the recovery of quality of life.