摘要
目的:探讨斜外侧入路椎间融合术(OLIF)联合后路内固定治疗腰椎管狭窄症(LSS)的临床效果。方法:选取2018年1月-2020年6月惠州市中心人民医院收治的76例行手术治疗的LSS患者,根据随机数字表法将患者分为OLIF组和经椎间孔腰椎椎体间融合术(TLIF)组,各38例。OLIF组采用斜外侧入路椎间融合术联合后路内固定治疗,TLIF组采用TLIF联合后路内固定治疗。术后1、3、6个月门诊随访。比较两组手术指标、视觉模拟评分法(visual analogue scale,VAS)评分、Oswestry功能障碍指数(Oswestry disability index,ODI)评分、椎间隙高度(disc height,DH)及腰椎前凸角(lumbar lordosis,LL)、C反应蛋白(CRP)、肌酸激酶(CK)及并发症发生情况。结果:OLIF组手术时间长于TLIF组,但术中出血量少于TLIF组,住院时间短于TLIF组,差异均有统计学意义(P<0.05)。两组椎间融合率比较,差异无统计学意义(P>0.05)。两组术前VAS、ODI评分比较,差异均无统计学意义(P>0.05);末次随访,两组VAS、ODI评分均低于术前,且OLIF组VAS、ODI评分均低于TLIF组,差异均有统计学意义(P<0.05)。术前,两组DH和LL水平比较,差异均无统计学意义(P>0.05);末次随访,两组DH和LL水平均高于术前,且OLIF组均高于TLIF组,差异均有统计学意义(P<0.05)。术前1 d,两组CRP、CK水平比较,差异均无统计学意义(P>0.05);术后24、48 h,OLIF组CRP、CK水平均低于TLIF组,差异均有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:与TLIF联合后路内固定相比,OLIF联合后路内固定治疗LSS患者可减轻手术对患者的创伤,缓解疼痛,改善脊柱功能,促进恢复,安全性高,值得应用。
Objective: To investigate the clinical efficacy of oblique lateral interbody fusion(OLIF) combined with posterior internal fixation in the treatment of lumbar spinal stenosis(LSS). Method: A total of 76 patients with LSS who underwent surgical treatment admitted to Huizhou Municipal Central Hospital from January 2018 to June 2020 were selected, according to the random number table method, the patients were divided into OLIF group and transforaminal lumbar interbody fusion(TLIF) group, 38 cases in each group. The OLIF group was treated with oblique lateral interbody fusion combined with posterior internal fixation, and the TLIF group was treated with TLIF combined with posterior internal fixation. Outpatient follow-up was conducted 1, 3, 6 months after surgery. The surgical parameters, visual analogue scale(VAS) scores, Oswestry disability index(ODI) scores, disc height(DH)and lumbar lordosis(LL), C reactive protein(CRP), creatine kinase(CK), and the occurrence of complications were compared between the two groups. Result: The surgical time of the OLIF group was longer than that of the TLIF group, but the intraoperative blood loss of the OLIF group was less than that of the TLIF group, and the hospital stay of the OLIF group was shorter than that of the TLIF group, the differences were statistically significant(P<0.05).There was no significant difference in the interbody fusion rate between the two groups(P>0.05). There were no significant differences in VAS scores and ODI scores between the two groups before surgery(P>0.05);at the last follow-up, VAS scores and ODI scores of both groups were lower than those before surgery, VAS score and ODI score of the OLIF group were lower than those of the TLIF group, the differences were statistically significant(P<0.05).Before surgery, there were no significant differences in DH and LL levels between the two groups(P>0.05);at the last follow-up, DH and LL levels of both groups were higher than those before surgery, those of the OLIF group were higher than those of the TLIF group, the differences were statistically significant(P<0.05). 1 d before surgery, there were no significant differences in CRP and CK levels between the two groups(P>0.05);24 and 48 h after surgery,CRP and CK levels of the OLIF group were lower than those of the TLIF group, the differences were statistically significant(P<0.05). There was no significant difference in the incidence of complications between the two groups(P>0.05). Conclusion: Compared with TLIF combined with posterior internal fixation, OLIF combined with posterior internal fixation in the treatment of LSS patients can reduce surgical trauma to patients, relieve pain, improve spinal function, promote recovery, and is safe and worthy of application.
作者
陈旭狮
葛小聪
刘启龙
李秀珍
姚仕奋
CHEN Xushi;GE Xiaocong;LIU Qilong;LI Xiuzhen;YAO Shifen(Huizhou Municipal Central Hospital,Guangdong Province,Huizhou 516001,China;不详)
出处
《中国医学创新》
CAS
2023年第2期21-26,共6页
Medical Innovation of China
基金
惠州市科技计划项目(210418234575032)。
作者简介
通信作者:陈旭狮。
