Stand-along OLIF植入3D打印解剖型融合器治疗退行性腰椎管狭窄症32例临床分析

Stand-along OLIF Implant Type 3D Printing Anatomy Fusion in Treatment of 32 Cases with Degenerative Lumbar Spinal Stenosis Disease

目的分析无内固定单纯斜外侧入路椎间融合术(Stand-along OLIF)植入自制3D打印解剖型融合器(3D anatomical type Cage)治疗退变性腰椎管狭窄症(Degenerative lumber spinal stenosis,DLSS)的临床疗效.方法32例退变性腰椎管狭窄症患者均行Stand-along OLIF手术,并采用视觉评分表(VAS)、Oswestry功能障碍指数(oswestry disability index,ODI)、SF-36生活质量量化表评价临床疗效;术前、术后1周、术后3个月、术后6个月、术后12个月及末次随访对手术节段的前缘椎间隙高度(DH)、后缘椎间隙高度(VH)、椎间孔高度(FH)及宽度(FW)、椎管前后矢状径(APD)、椎管横截面积(CSA)等参数进行影像学对比.结果32例患者术后1周至末次随访VAS评分和ODI指数均显著降低,SF-36显著增高(P<0.05);术后1周至末次随访DH、VH、FH、FW、APD及CSA均显著提高(P<0.05).结论Stand-alone OLIF植入3D打印解剖型融合器治疗DLSS具有创伤小、术后康复快、有效改善患者临床症状的优势.

Objective To analyze the clinical effect of the treatment of degenerative lumbar spinal stenosis(Dege-nerative lumber spinal stenosis,DLSS)with self-made 3D-printed anatomic fusion cage(3D anatomical type Cage)by single oblique lateral interbody fusion without internal fixation(Stand-along OLIF).Method 32 patients with degenerative lumbar spinal stenosis disease were in Stand-along OLIF surgery.The clinical efficacy was evaluated by visual analogue scale(VAS),Oswestry Disability Index(ODI)and SF-36 quality of life scale;Preoperative,postoperative 1 week,postoperative 3 months,postoperative 6 months,postoperative 12 months and the last follow-up were performed to compare the parameters of anterior(DH)and posterior border intervertebral space(VH),intervertebral foramen height(FH)and width(FW),anterior and posterior sagittal diameter(APD)and vertebral canal cross-sectional area(CSA).Results The VAS score and ODI index significantly decreased and SF-36 significantly increased in 32 patients(P<0.05);DH,VH,FH,FW,APD and CSA significantly increased from 1 week to the last follow-up(P<0.05).Conclusion Stand-alone OLIF for DLSS has the advantages of minimal invasion,rapid postoperative recovery and effective improvement.