TLIF与OLIF联合后路内固定治疗腰椎退行性疾病的疗效比较

目的比较斜外侧腰椎椎间融合术(OLIF)联合后路椎弓根钉棒内固定术与经椎间孔入路腰椎间融合术(TLIF)治疗退行性腰椎疾病的疗效。方法回顾性分析2018年3月至2022年11月65例行手术治疗的退行性腰椎疾病患者的临床资料,其中35例行OLIF联合后路椎弓根钉棒内固定术治疗(OLIF组),30例行经椎间孔入路腰椎间融合术治疗(TLIF组)。记录两组围术期相关指标、术后并发症发生情况,比较两组术前、术后1个月、术后3个月疼痛视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI),以及术前、术后椎间隙及椎间孔高度。结果与TLIF组比较,OLIF组术中出血量、术后下地行走时间、术后住院时间、术后椎间隙高度、椎间孔高度、术后椎间隙及椎间孔高度、VAS评分、ODI指数及并发症发生率均有优势(P<0.05)。结论两种手术方式均能有效治疗退行性腰椎疾病,OLIF联合后路椎弓根钉棒内固定术对椎间隙及椎间孔恢复更具有优势,术中出血少,术后恢复更快,在单节段退行性腰椎疾病的治疗效果更优。

Objective To compare the clinical efficacy of oblique lateral lumbar interbody fusion(OLIF)combined with posterior pedicle rod fixation and transforaminal lumbar interbody fusion(TLIF)in the treatment of degenerative lumbar spine diseases.Methods A retrospective analysis was conducted on the clinical data of 65 patients with degenerative lumbar spine disease who underwent surgery in our hospital from March 2018 to November 2022.Among them,35 patients were treated with OLIF combined with posterior pedicle rod fixation(the OLIF group),30 patients were treated with TLIF(the TLIF group).The perioperative indexes and the occurrence of recent postoperative complications were recorded between the two groups,and the visual analogue score(VAS)and Oswestry dysfunction index(ODI)of pain before,1 month and 3 months after surgery were compared,as well as the differences in the height of intervertebral space and intervertebral foramen before and after surgery.Results Compared with the TLIF group,the OLIF group had advantages in intraoperative blood loss,postoperative walking time,postoperative hospital stay,postoperative intervertebral space height,intervertebral foramen height,postoperative height improvement,surgical VAS score,ODI index and postoperative complication rate(P<0.05).Conclusion Both surgical methods can effectively treat degenerative lumbar spine diseases,OLIF combined with posterior pedicle rod fixation has more advantages for intervertebral space and intervertebral foramen recovery,less intraoperative bleeding,faster postoperative recovery,and better treatment effect in single-segment degenerative lumbar spine diseases.