[1]潘玉军,时长江,穆怀昭,等.斜外侧腰椎椎间融合术与经椎间孔椎间融合术治疗退行性腰椎侧凸疗效比较[J].中华老年骨科与康复电子杂志,2021,(06):345-351.[doi:10.3877/cma.j.issn.2096-0263.2021.06.005]
　Pan Yujun,Shi Changjiang,Mu Huaizhao,et al.Comparison of Oblique Lateral Lumbar Interbody Fusion and Transforaminal Interbody Fusion for The Treatment of Degenerative Lumbar Scoliosis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2021,(06):345-351.[doi:10.3877/cma.j.issn.2096-0263.2021.06.005]
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斜外侧腰椎椎间融合术与经椎间孔椎间融合术治疗退行性腰椎侧凸疗效比较()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2021年06期
页码:
345-351
栏目:
脊柱专题
出版日期:
2021-12-05

文章信息/Info

Title:
Comparison of Oblique Lateral Lumbar Interbody Fusion and Transforaminal Interbody Fusion for The Treatment of Degenerative Lumbar Scoliosis
作者:
潘玉军1; 时长江2; 穆怀昭3; 张义龙1
067000承德医学院附属医院脊柱外科1，关节外科2，创伤骨科3
Author(s):
Pan Yujun1;  Shi Changjiang2;  Mu Huaizhao3;  Zhang Yilong1.
1Department of Spine Surgery, Affiliated Hospital of Chengde Medical College, Chengde 067000, China; 2Department of Joint Surgery, Affiliated Hospital of Chengde Medical College, Hebeichengde 067000, China; 3Department of Trauma department of orthopedics, Affiliated Hospital of Chengde Medical College, Chengde 067000, China
关键词:
斜外侧腰椎椎间融合术;  经椎间孔椎间融合术;  退行性腰椎侧凸
Keywords:
Oblique lumbar interbody fusion;  Transforminal lumbar interbody fusion;  Degenerative lumbar scoliosis
DOI:
10.3877/cma.j.issn.2096-0263.2021.06.005
文献标志码:
A
摘要:
目的 探讨斜外侧腰椎椎间融合术（OLIF）与经椎间孔椎间融合术（TLIF）治疗退行性腰椎侧凸（DLS）的疗效差异。方法 回顾性分析2017年2月至2019年2月我院收治的DLS患者134例，根据不同手术方式分为OLIF组（64例）和TLIF组（70例）；比较两组患者的手术相关指标、并发症发生情况、融合率。分别于术前、术后6个月、2年评价视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI），计算冠状位、矢状位Cobb角、腰椎前凸角、骶骨倾斜角、骨盆入射角。结果 134例患者均获得完整随访，随访率100%，随访时间（35±4）个月。OLIF组手术时间[（243±39）min]显著高于TLIF组[（215±29）min，t=3.432，P=0.001]，OLIF术组术中出血量[（411±34）ml]显著低于对照组[（653±42）ml，t=4.865，P＜0.001]；两组术后6个月、2年ODI指数、VAS评分以及冠状位Cobb角均低于术前，矢状位Cobb角、腰椎前凸角、骶骨倾斜角、骨盆入射角高于术前，但术后3个月、2年OLIF术组冠状位Cobb角[（22.2±3.2）°，（22.2±3.2）°]显著高于TLIF组[（20.1±2.0）°、（20.1±2.0）°，t=4.534、t=4.798，P＜0.001]，术后3个月、2年OLIF组冠状位Cobb角[（3.2±0.4）°、（3.5±0.3）°]，显著低于TLIF组[（5.5±1.0）°、（5.6±0.8）°，t=16.265、t=20.595，P＜0.001]，术后3个月、术后2年OLIF组腰椎前凸角[（47.2±3.2）°、（46.9±2.6）°]显著高于TLIF组[（39.2±3.2°、38.9±2.4°，t=14.602，t=18.498，P＜0.001]，术后3个月、2年OLIF组骶骨倾斜角[（34.8±4.3）°、（34.4±4.0）°]显著高于TLIF组[（30.4±4.2）°、（30.0±3.9）°，t=5.964，t=6.494，P＜0.001]。结论 TLIF术、OLIF术治疗DLS均能获得确切的近期疗效，OLIF术手术时间略长，但创伤更小，冠状位、矢状位矫正效果更好。
Abstract:
Objective To investigate the difference between oblique lateral lumbar interbody fusion (OLIF) and transforaminal interbody fusion (TLIF) for the treatment of degenerative lumbar scoliosis (DLS). Methods A retrospective analysis of 134 patients with DLS admitted to our hospital from February 2017 to February 2019. According to different surgical methods, they were divided into OLIF operation group (64 cases) and TLIF operation group (70 cases), the two groups of patients were compared for operation related Indicators, complications, fusion rate were compared, and visual analog scale (VAS) and Oswestry disability index (ODI) were evaluated preoperatively, 6 months, and 2 years postoperatively. The coronal position, sagittal Cobb angle, lumbar lordosis angle, sacral tilt angle, pelvic incidence angle were calculated. Results The operation time of the OLIF group was (243±39) min, which was significantly higher than that of the TLIF group (215±29) min, (t=3.432, P=0.001). The intraoperative blood loss in the OLIF group was (411±34) ml, Significantly lower than the control group (653±42) ml, (t=4.865, P<0.001); the ODI index, VAS score, and coronal Cobb angle of the two groups were lower than that of the operation 6 months after the operation and 2 years after the operation. The sagittal Cobb angle, lumbar lordosis angle, sacral inclination angle, and pelvic angle of incidence were higher than those before surgery, but the coronal Cobb angles in the OLIF surgery group were (22.2±3.2)° at 3 months and 2 years after surgery (22.2±3.2)°, significantly higher than (20.1±2.0)°, (20.1±2.0)°, (t=4.534, t=4.798, P<0.001) in the TLIF group, 3 months after operation, 2 years postoperatively, the coronal Cobb angles in the OLIF group were (3.2±0.4)° and (3.5±0.3)°, which were significantly lower than the (5.5±1.0)° and (5.6±0.8)° in the TLIF group, (t=16.265, t=20.595, P<0.001), the lumbar lordosis angles of the OLIF operation group were (47.2±3.2)° and (46.9±2.6)° at 3 months and 2 years after operation, which were significantly higher than those of TLIF (39.2±3.2)°, (38.9±2.4)°, (t=14.602, t=18.498, P<0.001) in the operation group, the sacral inclination angles of the OLIF operation group at 3 months and 2 years after the operation were respectively (34.8±4.3)° and (34.4±4.0)° were significantly higher than (30.4±4.2)° and (30.0±3.9)° in the TLIF group, (t=5.964, t=6.494, both P<0.001). Conclusion Both TLIF and OLIF can obtain definite short-term curative effects in the treatment of DLS. OLIF has a slightly longer operation time, but has less trauma and better coronal and sagittal correction effects.

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备注/Memo

备注/Memo:
基金项目：承德市科技计划项目 (201801A050)
更新日期/Last Update: 2022-04-25