不同手术方式对腰椎退行性疾病的疗效

Efficacy of Different Surgical Procedures in Degenerative Lumbar Spine Diseases

目的不同手术方式对腰椎退行性疾病的疗效及对其炎症指标和预后的影响。方法选取2020年10月至2022年7月周口骨科医院收治的72例腰椎退行性疾病患者,根据术式分为两组。研究组患者40例,接受斜外侧腰椎椎间融合术(OLIF)手术治疗,对照组患者32例,接受微创经皮椎管减压后外侧融合手术(mis-PLIF)手术治疗,比较两组患者的临床疗效等差异。结果研究组围手术期指标优于对照组(P<0.05);术前两组的炎症指标比较差异无统计学意义(P>0.05),术后两组炎症指标均较术前降低,且研究组低于对照组(P<0.05);与术前比较,术后两组患者的椎间隙前缘、后缘高度增加,研究组术后的椎间隙前缘高度高于对照组(P<0.05);术前两组椎管矢状径比较差异无统计学意义(P>0.05),术后两组的椎管矢状径均较术前增加,且研究组低于对照组(P<0.05);术前两组视觉模拟评分法(VAS)评分及Oswestry功能障碍指数(ODI)比较差异无统计学意义(P>0.05),术后两组VAS评分及ODI均降低,且研究组低于对照组(P<0.05)。结论OLIF治疗腰椎退行性疾病的效果更佳,值得临床推广应用,但应严格掌握其手术适应证。

Objective To investigate the efficacy of different surgical procedures in degenerative lumbar spine diseases and their impact on inflammatory indexes and prognosis.Methods Seventy-two patients with degenerative lumbar spine disease in Zhoukou Orthopedic Hospital form October 2020 to July 2022 were selected and divided into two groups according to the surgical procedures.Among them,40 patients in the study group were treated with oblique lateral interbody fusion(OLIF)surgery,while 32 patients in the control group were treated with minimally invasive surgery transforaminal lumbar interbody fusion(mis-PLIF)surgery.The clinical efficacy and other differences were compared between the two groups.Results The perioperative indexes of the study group were better than those of the control group(P<0.05).There were no differences in the inflammatory indexes between the two groups before surgery(P>0.05),and the inflammatory indexes in both groups after surgery were lower than before surgery,and the study group was lower than the control group(P<0.05).Compared with the preoperative period,the anterior and posterior marginal heights of the vertebral space in both groups increased after surgery,and the anterior marginal height of the vertebral space in the study group was higher than that of the control group after surgery(P<0.05).There was no difference in the sagittal diameter of the spinal canal between the two groups before surgery(P>0.05),the sagittal diameter of the spinal canal increased in both groups after surgery,and the study group was lower than the control group(P<0.05).There were no differences in the visual analogue scale(VAS)score and Oswestry disability index(ODI)between the two groups before surgery(P>0.05),and the VAS score and ODI decreased in both groups after surgery,and the study group was lower than the control group(P<0.05).Conclusion OLIF has better efficacy in the treatment of lumbar degenerative diseases and is worthy of clinical promotion,but its indications for surgery should be strictly controlled.