[1]张盼可 朱广铎 任志楠 于磊 朱剑 曹书严 宋鑫镐 英杰**.斜外侧与后路腰椎间融合治疗腰椎融合术后邻近节段退变性疾病的比较[J].中国微创外科杂志,2022,01(1):7-13.
 Zhang Panke,Zhu Guangduo,Ren Zhinan,et al.Comparison of Clinical Efficacy of Oblique Lumbar Interbody Fusion and Posterior Lumbar Interbody Fusion in the Treatment of Adjacent Segment Degenerative Diseases After Lumbar Fusion[J].Chinese Journal of Minimally Invasive Surgery,2022,01(1):7-13.
点击复制

斜外侧与后路腰椎间融合治疗腰椎融合术后邻近节段退变性疾病的比较()
分享到:

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2022年1期
页码:
7-13
栏目:
临床研究
出版日期:
2022-04-07

文章信息/Info

Title:
Comparison of Clinical Efficacy of Oblique Lumbar Interbody Fusion and Posterior Lumbar Interbody Fusion in the Treatment of Adjacent Segment Degenerative Diseases After Lumbar Fusion
作者:
张盼可 朱广铎 任志楠 于磊 朱剑 曹书严 宋鑫镐 英杰**
(郑州大学第一附属医院骨科,郑州450052)
Author(s):
Zhang Panke Zhu Guangduo Ren Zhinan et al.
Department of Orthopedics, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
关键词:
斜外侧腰椎间融合术后路腰椎间融合术腰椎邻近节段退变翻修手术
Keywords:
Oblique lumbar interbody fusion (OLIF)Posterior lumbar interbody fusion (PLIF)Adjacent segment degenerative diseaseRevision surgery
文献标志码:
A
摘要:
目的比较斜外侧腰椎间融合(oblique lumbar interbody fusion,OLIF)和后路腰椎间融合(posterior lumbar interbody fusion,PLIF)治疗腰椎融合术后邻近节段退变性疾病的疗效。方法回顾性分析2016年1月~2019年12月腰椎融合术后邻近节段退变54例翻修手术资料,由患者选择手术方式,其中OLIF 25例,PLIF 29例,2组年龄、性别、手术节段、术前融合节段、邻近节段退变类型差异无统计学意义(P>0.05)。比较2组围术期指标及末次随访改良MacNab标准优良率。结果与PLIF组相比,OLIF组手术时间短[(111.8±42.4)min vs. (203.9±53.1)min,t=-6.695,P=0.000],术中出血少[(103.6±74.0)ml vs. (545.5±256.2)ml,t=-8.869,P=0.000],术后住院时间短[(8.5±2.2)d vs. (13.8±5.1)d,t=-5.154,P=0.000]。2组围术期并发症差异无统计学意义(P>0.05)。2组随访时间差异无统计学意义[(19.5±3.9)月vs. (18.1±3.8)月,t=1.352,P=0.182]。末次随访改良MacNab标准优良率,OLIF组96.0%(24/25),PLIF组89.7%(26/29),差异无统计学意义(χ2=0.788,P=0.375)。结论OLIF和PLIF治疗腰椎融合术后邻近节段退变性疾病均有良好疗效。与PLIF组相比,OLIF具有手术时间、住院时间短,术中出血少等优势。
Abstract:
ObjectiveTo compare the clinical efficacy of oblique lumbar interbody fusion (OLIF) and posterior lumbar interbody fusion (PLIF) in the treatment of adjacent segment degenerative diseases after lumbar fusion.MethodsA total of 54 patients with adjacent segment degeneration after lumbar fusion from January 2016 to December 2019 were retrospectively included. The patients were divided into the OLIF group (n=25) or PLIF group (n=29) according to their choice of different surgical methods. No significant differences in age, gender, surgical segment, preoperative fusion segment and type of adjacent segment degeneration were found between the two groups (P>0.05). The perioperative indicators and the modified MacNab criteria at the last followup between the two groups were compared.ResultsCompared with the PLIF group, the OLIF group had shorter operation time [(1118±42.4) min vs. (203.9±53.1) min, t=-6.695, P=0.000], less intraoperative blood loss [(103.6±74.0) ml vs. (545.5±256.2) ml, t=-8.869, P=0.000], and shorter postoperative hospital stay [(8.5±2.2) d vs. (13.8±5.1) d, t=-5.154, P=0.000]. There was no significant difference in perioperative complications between the two groups (P>0.05). No significant difference was found in followup time between the two groups [(19.5±3.9) month vs. (18.1±3.8) month, t=1.352, P=0.182]. There were no significant differences in excellent and good rate between the OLIF group (96.0%, 24/25) and the PLIF group (89.7%, 26/29) at the final followup (χ2=0.788, P=0.375).ConclusionsBoth OLIF and PLIF have good curative effects in the treatment of the adjacent segment degenerative diseases after lumbar surgery. However, compared with the PLIF, OLIF has advantages of shorter operation time, shorter hospital stay, and less intraoperative bleeding.

参考文献/References:

[1]Kaiser MG,Eck JC,Groff MW,et al.Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine.Part 1:introduction and methodology.J Neurosurg Spine,2014,21(1):2-6.
[2]Okuda S,Nagamoto Y,Matsumoto T,et al.Adjacent segment disease after single segment posterior lumbar interbody fusion for degenerative spondylolisthesis:minimum 10 years followup.Spine (Phila Pa 1976),2018,43(23):E1384-E1388.
[3]Makino T,Honda H,Fujiwara H,et al.Low incidence of adjacent segment disease after posterior lumbar interbody fusion with minimum disc distraction:a preliminary report.Medicine (Baltimore),2018,97(2):e9631.
[4]Bydon M,Macki M,Kerezoudis P,et al.The incidence of adjacent segment disease after lumbar discectomy:a study of 751 patients.J Clin Neurosci,2017,35:42-46.
[5]李东生,黄保华.腰椎椎体后缘离断症及其脊柱内镜治疗进展.中国微创外科杂志,2021,21(8):751-754.
[6]Rao PJ,Loganathan A,Yeung V,et al.Outcomes of anterior lumbar interbody fusion surgery based on indication:a prospective study.Neurosurgery,2015,76(1):7-23.
[7]Ozgur BM,Aryan HE,Pimenta L,et al.Extreme lateral interbody fusion (XLIF):a novel surgical technique for anterior lumbar interbody fusion.Spine J,2006,6(4):435-443.
[8]Kim SJ,Lee YS,Kim YB,et al.Clinical and radiological outcomes of a new cage for direct lateral lumbar interbody fusion.Korean J Spine,2014,11(3):145-151.
[9]Hijji FY,Narain AS,Bohl DD,et al.Lateral lumbar interbody fusion:a systematic review of complication rates.Spine J,2017,17(10):1412-1419.
[10]Abe K,Orita S,Mannoji C,et al.Perioperative complications in 155 patients who underwent oblique lateral interbody fusion surgery:perspectives and indications from a retrospective,multicenter survey.Spine (Phila Pa 1976),2017,42(1):55-62.
[11]Zhong ZM,Deviren V,Tay B,et al.Adjacent segment disease after instrumented fusion for adult lumbar spondylolisthesis:incidence and risk factors.Clin Neurol Neurosurg,2017,156:29-34.
[12]Maragkos GA,MotieiLangroudi R,Filippidis AS,et al.Factors predictive of adjacent segment disease after lumbar spinal fusion.World Neurosurg,2020,133:e690-e694.
[13]双峰,侯树勋.腰椎融合术后邻近节段退变的临床研究现状.中国修复重建外科杂志,2013,27(1):110-115.
[14]Wu M,Li J,Zhang M,et al.Efficacy and radiographic analysis of oblique lumbar interbody fusion for degenerative lumbar spondylolisthesis.J Orthop Surg Res,2019,14(1):399.
[15]许朝君,镐英杰,于磊,等.斜外腰椎间融合术治疗退变性腰椎侧凸.中国矫形外科杂志,2020,28(13):1185-1190.
[16]朱广铎,镐英杰,于磊,等.斜外侧入路与后路腰椎间融合术治疗腰椎间融合术后椎间融合器移位的疗效比较.中国修复重建外科杂志,2020,34(6):761-768.
[17]王海峰,曾忠友,金辉.后路腰椎椎间融合术中使用皮质骨轨迹螺钉或椎弓根螺钉治疗腰椎退行性疾病.脊柱外科杂志,2020,18(1):53-57.
[18]He W,He D,Sun Y,et al.Standalone oblique lateral interbody fusion vs. combined with percutaneous pedicle screw in spondylolisthesis.BMC Musculoskelet Disord,2020,21(1):184.
[19]Kaiser MG,Haid RJ,Subach BR,et al.Comparison of the miniopen versus laparoscopic approach for anterior lumbar interbody fusion:a retrospective review.Neurosurgery,2002,51(1):97-103.

备注/Memo

备注/Memo:
基金项目:河南省医学科技攻关计划省部共建项目(SB201903001)**通讯作者,Email:haojack77@126.com
更新日期/Last Update: 2022-04-07