[1]吴静晔 葛腾辉 李观清 敖进涛 徐忠宁 孙宇庆**.斜外侧入路与经椎间孔椎间融合术治疗退行性腰椎滑脱2年随访结果的对比研究[J].中国微创外科杂志,2024,01(9):593-598.
　Wu Jingye,Ge Tenghui,Li Guanqing,et al.A Comparative Study of Oblique and Transforaminal Lumbar Interbody Fusion for Degenerative Spondylolisthesis at Postoperative 2 Years[J].Chinese Journal of Minimally Invasive Surgery,2024,01(9):593-598.
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斜外侧入路与经椎间孔椎间融合术治疗退行性腰椎滑脱2年随访结果的对比研究()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2024年9期
页码:
593-598
栏目:
临床论著
出版日期:
2024-09-25

文章信息/Info

Title:
A Comparative Study of Oblique and Transforaminal Lumbar Interbody Fusion for Degenerative Spondylolisthesis at Postoperative 2 Years
作者:
吴静晔 葛腾辉 李观清 敖进涛 徐忠宁 孙宇庆**
(首都医科大学附属北京积水潭医院脊柱外科，北京100035)
Author(s):
Wu Jingye;  Ge Tenghui;  Li Guanqing;  et al.
Department of Spine Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035, China
关键词:
椎间融合术; 斜外侧入路椎间融合术; 腰椎滑脱; 对比研究
Keywords:
Interbody fusion; Oblique lumbar interbody fusion; Lumbar spondylolisthesis; Comparative study
文献标志码:
A
摘要:
目的比较斜外侧入路椎间融合术(oblique lumbar interbody fusion，OLIF)和经椎间孔椎间融合术(transforaminal lumbar interbody fusion，TLIF)治疗退行性腰椎滑脱术后2年的临床疗效。方法回顾性分析2017年7月~2020年9月OLIF(46例)和TLIF(45例)治疗退行性腰椎滑脱2年随访资料，融合范围1~2个腰椎节段。主要观察指标为术后2年疼痛视觉模拟量表(Visual Analogue Scale，VAS)和Oswestry功能障碍指数(Oswestry Disability Index，ODI)，次要观察指标为术后2年影像学参数、椎间融合、融合器沉降和永久性神经损伤发生率。结果OLIF和TLIF术后2年腰痛VAS［2(2,3) vs.2(2,2),P=0.943］、下肢痛VAS［2(2,2) vs.2(2,2),P=0.988］和ODI［17%(10%,22%) vs.14%(10%,22%),P=0.417］差异均无显著性。OLIF术后2年椎间高度优于TLIF［(11.9±1.5) mm vs.(9.2±2.0)mm，P<0.001］，节段前凸角度优于TLIF(15.7°±7.2° vs. 12.5°±5.9°，P=0.029)，且融合器沉降率低［19.6%(9/46) vs. 40.0%(16/40)，P=0.037］。2组术后2年融合率［93.5%(43/46) vs.87.5%(35/40)，P=0.562］和永久性神经损伤发生率［4.3%(2/46)vs.6.7%(3/45)，P=0980］差异均无显著性。结论对于退行性腰椎滑脱，短节段OLIF和TLIF术后2年在症状改善和融合率方面表现相似，但OLIF椎间高度和前凸角度恢复更显著，且融合器沉降率较低。
Abstract:
ObjectiveTo compare the clinical outcomes between oblique lumbar interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF) for patients with degenerative spondylolisthesis during 2year followups.MethodsPatients with symptomatic degenerative spondylolisthesis who underwent OLIF (46 cases) and TLIF (45 cases) between July 2017 and September 2020 with 2year followups were retrospectively reviewed. One level or twolevel lumbar fusion were included. The primary outcomes were Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) at 2 years after surgery. The secondary outcomes included radiographic parameters, fusion rate, cage subsidence rate, and permanent nerve injury rate.ResultsNo significantly different changes were noted in VASback ［2 (2, 3) vs. 2 (2, 2), P=0.943］, VASleg ［2 (2, 2) vs. 2 (2, 2), P=0.988］, and ODI ［17% (10%, 22%) vs. 14% (10%, 22%), P=0.417］ between the OLIF group and the TLIF group, respectively. Greater restoration of disc height and segmental lordosis were obtained in the OLIF group ［mean, (11.9±1.5) mm and 15.7°±7.2°］ than in the TLIF group ［mean, (9.2±2.0) mm and 12.5°±5.9°］ at postoperative 2year (P<0.001 and P=0.029). The subsidence rate was lower in the OLIF group than in the TLIF group ［19.6% (9/46) vs. 40.0% (16/40), P=0.037］. The fusion rates at postoperative 2year were 93.5% (43/46) in the OLIF group and 87.5% (35/40) in the TLIF group, having no significant difference (P=0.562). The rates of permanent nerve injury were similar between the two groups ［4.3% (2/46) vs. 6.7% (3/45), P=0980］ at postoperative 2year.ConclusionShort segment OLIF doesn’t show better clinical outcomes and fusion rate than TLIF for degenerative spondylolisthesis, except for greater disc height restoration, greater segmental lordosis, and lower subsidence rate at postoperative 2year.

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备注/Memo

备注/Memo:
基金项目：国家重点研发计划(2022YFC2407200，2022YFC2407204)**通讯作者，Email：syuqing2004@126.com
更新日期/Last Update: 2024-12-17