采用微创腰椎椎间融合联合椎弓根钉棒固定治疗腰椎滑脱症的临床疗效

目的 探讨腰椎侧方入路融合术(OLIF)联合椎弓根钉棒固定(Wiltse入路)置入治疗腰椎滑脱症(LS)的临床疗效.方法 2017年1月至2020年7月江苏省连云港市灌云县人民医院骨科收治的腰椎滑脱症患者27例,在正常L3～S1节段CT扫描的基础上采用OLIF联合Wiltse入路的方法,设为观察组;同时以单纯小切口 W...

Application value of oblique lateral interbody fusion combined with Wiltse approach in lumbar spondylolisthesis

Objective To explore the clinical application value of oblique lateral interbody fusion(OLIF)combined with pedicle screw fixation(Wiltse approach)in the treatment of lumbar spondylolisthesis.Methods On the basis of normal L3-S1 segmental CT scanning,27 patients with lumbar spondylolisthesis treated by OLIF combined with Wiltse approach in the department of spinal orthopedics,the People's Hospital of Guanyun County,were selected as the observation group from January 2017 to July 2020.In the control group,27 patients were treated by traditional anterior focus debridement combined with posterior internal fixation,Exposure,exposure and total bleeding,JOA improvement rate,and lower back pain VAS score of the two groups of surgery were compared.In addition,responsibility segments were set to build OLIF Stand alone(M1)model,OLIF+left arch bar fixation model(M2)and OLIF+(M3).The relative activity,gradual fusion period and stress distribution of different segments of the anterior flexion,posterior extension,lateral flexion and rotation of the three models were compared.Result Compared with OLIF stand alone(M1)model,OLIF+left pedicle screw fixation model(M2)and OLIF+bilateral pedicle screw fixation model(M3)were more effective in the treatment of lumbar spondylolisthesis.The intraoperative indexes(operation time,exposure time,exposed blood volume and total blood loss)in the combined group(OLIF combined with small incision Wiltse approach)were lower than those in the routine treatment group(P<0.05).The improvement rate of JOA and the VAS score of low back pain in the combined group were better than those in the routine treatment group(P<0.05).Conclusion OLIF combined with Wiltse approach is more effective in the clinical treatment of lumbar spondylolisthesis and can provide sufficient intervertebral stability for lumbar interbody fusion.