斜侧方/经椎间孔入路腰椎椎间融合术治疗退行性腰椎滑脱的近期疗效

目的　比较斜侧方入路腰椎椎间融合术(OLIF)与经椎间孔入路腰椎椎间融合术(TLIF)治疗退行性腰椎滑脱(DLS)的近期疗效。方法回顾性分析海军军医大学附属长征医院2018年1月—2018年6月收治的30例DLS患者临床资料,其中采用OLIF治疗15例(OLIF组)、采用TLIF治疗15例(TLIF组)。记录2组手术时间、术中出血量、椎间融合、椎间孔高度及椎间高度恢复情况等;采用疼痛视觉模拟量表(VAS)评分评估腰腿疼痛程度;采用Oswestry功能障碍指数(ODI)评估术后功能恢复情况。结果所有手术顺利完成。所有患者随访(8.5±2.3)个月,末次随访时OLIF组均获得椎间融合,TLIF组1例未完全融合。OLIF组手术时间、术中出血量均少于TLIF组,差异有统计学意义(P 0.05)。2组术后1 d及末次随访VAS评分、ODI均较术前显著改善,差异有统计学意义(P 0.05);术后1 d及末次随访VAS评分组间相比差异无统计学意义(P 0.05);OLIF组术后1 d及末次随访ODI优于TLIF组,差异有统计学意义(P 0.05)。2组术后1 d及末次随访椎间孔高度及椎间高度均较术前明显改善,且术后1 d时OLIF组优于TLIF组,差异均有统计学意义(P 0.05)。结论 2种术式治疗DLS近期临床疗效良好。OLIF创伤小,ODI、椎间和椎间孔高度恢复优于TLIF。

Short-term effects of oblique/transforaminal lumbar interbody fusion for degenerative lumbar spondylolisthesis

Objective To compare the short-term efficacy of oblique lumbar interbody fusion(OLIF) and transforaminal lumbar interbody fusion(TLIF) in the treatment of degenerative lumbar spondylolisthesis. Methods The clinical data of 30 patients with degenerative lumbar spondylolisthesis(DLS) admitted to Changzheng Hospital Affiliated to Navy Medical University from January 2018 to June 2018 were analyzed retrospectively. Fifteen patients were treated with OLIF(OLIF group) and the other 15 with TLIF(TLIF group). The operation time,intraoperative blood loss,intervertebral fusion,changes of intervertebral height and intervertebral foramen height were compared between the 2 groups. Visual analogue scale(VAS) was used to evaluate the back and leg pain,and Oswestry dysfunction index(ODI) was used to evaluate the functional recovery at pre- and post-operation. Results All the operations were completed successfully. All the patients were followed up for (8.5±2.3)months. At the final follow-up,all the patients in OLIF group got intervertebral fusion,while 1 patient in TLIF group did not complete fusion. The operation time and blood loss in OLIF group were less than those in TLIF group,and the differences were statistically significant(P<0.05). The VAS score and ODI of the 2 groups were significantly improved at postoperative 1 d and the final follow-up compared with per-operation,all with statistical significances(P<0.05);there was no significant difference in VAS score between the 2 groups at postoperative 1 d and the final follow-up(P>0.05);the ODI of OLIF group was better than that of TLIF group at postoperative 1 d and the final follow-up,with a statistical significance(P<0.05). The intervertebral height and intervertebral foramen height of the 2 groups were significantly improved at postoperative 1 d and the final follow-up compared with per-operation,and OLIF group was better than TLIF group at postoperative 1 d,and the differences were statistically significant(P<0.05). Conclusion The short-term clinical efficacy of the 2 methods for DLS is satisfactory. OLIF has less trauma,and is superior to TLIF in the recovey of ODI,intervertebral height and intervertebral foramen height.