[1]王海宾,刘恩,吕飞,等.斜外侧腰椎椎间融合术治疗退行性腰椎管狭窄的疗效分析[J].中华老年骨科与康复电子杂志,2022,(04):224-230.[doi:10.3877/cma.j.issn.2096-0263.2022.04.006]
　Wang Haibin,Liu En,Lyu Fei,et al.Clinical analysis of oblique lateral lumbar interbody fusion in the treatment of degenerative lumbar spinal stenosis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2022,(04):224-230.[doi:10.3877/cma.j.issn.2096-0263.2022.04.006]
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斜外侧腰椎椎间融合术治疗退行性腰椎管狭窄的疗效分析()
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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:
2022年04期
页码:
224-230
栏目:
脊柱专题
出版日期:
2022-08-05

文章信息/Info

Title:
Clinical analysis of oblique lateral lumbar interbody fusion in the treatment of degenerative lumbar spinal stenosis
作者:
王海宾1; 刘恩2; 吕飞3; 韩清清1; 张俊芬2
056200 邯郸，峰峰集团总医院骨科1，骨四科2，骨五科3
Author(s):
Wang Haibin1;  Liu En2;  Lyu Fei3;  Han Qingqing1;  Zhang Junfen2
1Department of Orthopaedics, 2Department of Orthopaedics 4, 3Department of Orthopaedics 5, Fengfeng Group General Hospital, 056200 Handan, China
关键词:
腰椎;  融合术;  椎管狭窄;  疗效;  并发症
Keywords:
Lumbar;  Fusion;  Spinal Stenoses;  Effect;  Complications
DOI:
10.3877/cma.j.issn.2096-0263.2022.04.006
文献标志码:
A
摘要:
目的 探讨斜外侧腰椎椎间融合术（OLIF）对退行性腰椎管狭窄患者腰椎功能的康复效果及对椎管内血液微循环、微炎状态的影响。方法 前瞻性收集峰峰集团总医院骨科住院部2018年1月至2019年1月间收治的退行性腰椎管狭窄症患者120例，采用随机数字表分组法（奇数入观察组，偶数入对照组）将其分为观察组（行OLIF）和对照组[行后路椎体间融合术（PLIF）]，各60例。比较两组手术时间、术中出血量、术后引流量及住院时间，治疗前及治疗后6个月腰椎疼痛视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI），血浆粘度（PV）、全血高切黏度（HBV）、全血低切黏度（LBV）、血沉（ESR）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、超敏C反应蛋白（hs-CRP）、单核细胞趋化蛋白-1（MCP-1）及临床并发症。结果 观察组手术时间、术中出血量、术后引流量及住院时间均少于对照组（P＜0.001）；观察组并发症总发生率（6.67%）低于对照组（21.67%，P＜0.05）；治疗前，两组VAS评分、ODI评分、PV、HBV、LBV、ESR、hs-CRP、IL-6、TNF-α、MCP-1水平比较差异无统计学意义（P＞0.05）；6个月后，两组VAS评分、ODI评分、PV、HBV、LBV、ESR、hs-CRP、IL-6、TNF-α、MCP-1水平均降低（P＜0.001），且观察组水平均低于对照组（P＜0.001）。结论 斜外侧腰椎椎间融合术可显著减轻退行性腰椎管狭窄患者术后腰椎疼痛程度，改善腰椎功能及椎管内血液微循环，降低炎症状态，临床疗效显著，且该术手术时间短、术中出血量及术后引流量少、住院时间短，术后并发症少，在退行性腰椎管狭窄的临床治疗中具有重要的应用价值。
Abstract:
Objective To investigate the effect of obliquely lateral lumbar interbody fusion (OLIF) on the recovery of lumbar function in patients with degenerative lumbar stenosis and its influence on the state of blood microcirculation and micro inflammation in the spinal canal. Methods 120 patients with degenerative lumbar spinal stenosis admitted to the orthopedic inpatient department of Fengfeng Group General Hospital from January 2018 to January 2019 were selected for prospective study. The patients were randomly divided into observation group (with olif) and control group (with PLIF), with 60 cases in each group. The operation time, intraoperative blood loss, postoperative drainage volume, hospitalization time, visual analogue scale (VAS), Oswestry disability index (ODI), plasma viscosity (PV), high blood viscosity (HBV), low cut whole blood viscosity (LBV), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), hypersensitive C-reactive protein (hs-CRP), monocyte chemoattractant protein-1 (MCP-1) were compared between the two groups and clinical complications.. Results The operation time, intraoperative hemorrhage, postoperative drainage and hospitalization time in the observation group were all less than those in the control group (P<0.001); the total incidence of complications in the observation group (6.67%) was lower than that in the control group (21.67%, P<0.05); before treatment, there was no significant difference in the levels of vas, ODI, PV, HBV, LBV, ESR, hs CRP, IL-6, TNF-α and MCP-1 between the two groups (P>0.05); six months later The levels of VAS, ODI, PV, HBV,LBV, ESR, hs CRP, IL-6, TNF-α and MCP-1 in the two groups were all decreased (P<0.001). The levels of VAS, ODI, PV, HBV, LBV, ESR, hs CRP, IL-6, TNF - α and MCP-1 in the observation group were lower than those in the control group (P<0.001). Conclusion OLIF can significantly reduce the degree of postoperative lumbar pain in patients with degenerative lumbar stenosis, improve the lumbar function and blood microcirculation in the spinal canal, reduce the state of inflammation, and has significant clinical effect. Moreover, the operation time is short, the amount of intraoperative bleeding and postoperative drainage is small, the length of hospitalization is short, and the postoperative complications are small. It has the following advantages in the clinical treatment of degenerative lumbar stenosis. Important application value.

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备注/Memo

备注/Memo:
基金项目：2018年度河北省医学科学研究重点课题计划（20181280）
更新日期/Last Update: 2022-09-29