斜外侧入路与微创经椎间孔入路椎间融合术治疗退变性腰椎滑脱的早期疗效及影像学对比

目的:比较斜外侧入路腰椎椎间融合术(oblique lumbar interbody fusion,OLIF)和Quadrant可扩张通道下微创经椎间孔入路腰椎椎间融合术(minimally invasive transforaminal lumbar interbody fusion,MIS-TLIF)治疗退变性腰椎滑脱的短期临床疗效及影像学差异。方法:对2019年4月至2020年10月行OLIF与MIS-TLIF两种微创手术方式治疗的58例腰椎滑脱患者进行回顾性分析。其中采用OLIF治疗28例(OLIF组),男15例,女13例;年龄47～84(63.00±9.38)岁;采用MIS-TLIF治疗30例(MIS-TLIF组),男17例,女13例;年龄43～78岁(61.13±11.10)岁。记录两组患者的一般情况,包括手术时间、术中出血量、术后引流量、并发症、卧床时间、住院时间;比较两组患者的影像学资料,包括椎间盘高度、椎间孔高度、腰椎前凸角;并通过疼痛视觉模拟评分(visual analogue scale,VAS)和Oswestry功能障碍指数(Oswestry disabilit...

Clinical and radiologic comparison between oblique lateral interbody fusion and minimally invasive transforaminal lumbar interbody fusion for degenerative lumbar spondylolisthesis

Objective To compare the short-term clinical efficacy and radiologic differences between oblique lateral interbody fusion(OLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for degenerative lumbar spondylolisthesis.Methods A retrospective analysis was performed on 58 patients with lumbar spondylolisthesis treated with OLIF or MIS-TLIF from April 2019 to October 2020. Among them,28 patients were treated with OLIF (OLIF group),including 15 males and 13 females aged 47 to 84 years old with an average age of (63.00±9.38) years. The other 30 patients were treated with MIS-TLIF(MIS-TLIF group),including 17 males and 13 females aged 43 to 78 years old with an average age of (61.13±11.10) years. General conditions,including operation time,intraoperative blood loss,postoperative drainage,complications,lying in bed,and hospitalization time were recorded in both groups. Radiological characteristics,including intervertebral disc height (DH),intervertebral foramen height (FH),and lumbar lordosis angle (LLA),were compared between two groups. The visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate the clinical effect.Results The operation time,intraoperative blood loss,postoperative drainage,lying in bed,and hospitalization time in OLIF group were significantly less than those in the MIS-TLIF group (P<0.05). The intervertebral disc height and intervertebral foramen height were significantly improved in both groups after the operation (P<0.05). The lumbar lordosis angle in OLIF group was significantly improved compared to before the operation (P<0.05),but there was no significant difference in the MIS-TLIF group before and after operation(P>0.05). Postoperative intervertebral disc height,intervertebral foramen height,and lumbar lordosis were better in the OLIF group than in the MIS-TLIF group (P<0.05). The VAS and ODI of the OLIF group were lower than those of the MIS-TLIF group within 1 week and 1 month after the operation (P<0.05),and there were no significant differences in VAS and ODI at 3 and 6 months after the operation between the two groups(P>0.05). In the OLIF group,1 case had paresthesia of the left lower extremity with flexion-hip weakness and 1 case had a collapse of the endplate after the operation;in the MIS-TLIF group,2 cases had radiation pain of lower extremities after decompression.Conclusion Compared with MIS-TLIF,OLIF results in less operative trauma,faster recovery,and better imaging performance after lumbar spine surgery.