Bergman Clinics, Naarden and NedSpine, Ede, The Netherlands.
Clin Interv Aging. 2013;8:1063-9. doi: 10.2147/CIA.S49802. Epub 2013 Aug 12.
The aim of this study is to report our 6-year single-center experience with L5-S1 axial lumbar interbody fusion (AxiaLIF).
A total of 131 patients with symptomatic degenerative disc disease refractory to nonsurgical treatment were treated with AxiaLIF at L5-S1, and were followed for a minimum of 1 year (mean: 21 months). Main outcomes included back and leg pain severity, Oswestry Disability Index score, working status, analgesic medication use, patient satisfaction, and complications. Computed tomography was used to determine postoperative fusion status.
No intraoperative complications, including vascular, neural, urologic, or bowel injuries, were reported. Back and leg pain severity decreased by 51% and 42%, respectively, during the follow-up period (both P < 0.001). Back function scores improved 50% compared to baseline. Clinical success, defined as improvement ≥30%, was 67% for back pain severity, 65% for leg pain severity, and 71% for back function. The employment rate increased from 47% before surgery to 64% at final follow-up (P < 0.001). Less than one in four patients regularly used analgesic medications postsurgery. Patient satisfaction with the AxiaLIF procedure was 83%. The fusion rate was 87.8% at final follow-up. During follow-up, 17 (13.0%) patients underwent 18 reoperations on the lumbar spine, including pedicle screw fixation (n = 10), total disc replacement of an uninvolved level (n = 3), facet screw fixation (n = 3), facet screw removal (n = 1), and interbody fusion at L4-L5 (n = 1). Eight (6.1%) reoperations were at the index level.
Single-level AxiaLIF is a safe and effective means to achieve lumbosacral fusion in patients with symptomatic degenerative disc disease.
本研究旨在报告我们在 L5-S1 轴向腰椎体间融合术（AxiaLIF）方面的 6 年单中心经验。
共 131 例症状性退行性椎间盘疾病患者经非手术治疗无效，在 L5-S1 处接受 AxiaLIF 治疗，并至少随访 1 年（平均 21 个月）。主要结果包括腰背疼痛严重程度、Oswestry 功能障碍指数评分、工作状态、镇痛药物使用、患者满意度和并发症。采用计算机断层扫描确定术后融合状态。
无术中并发症，包括血管、神经、泌尿科或肠道损伤。随访期间腰背疼痛严重程度分别下降 51%和 42%（均 P < 0.001）。与基线相比，腰背功能评分提高了 50%。临床成功率定义为改善≥30%，腰背疼痛严重程度为 67%，下肢疼痛严重程度为 65%，腰背功能为 71%。手术前的就业率为 47%，最后随访时为 64%（P < 0.001）。术后不到四分之一的患者定期使用镇痛药。AxiaLIF 手术的患者满意度为 83%。最后随访时融合率为 87.8%。随访期间，17 例（13.0%）患者接受了 18 次腰椎再手术，包括椎弓根螺钉固定术（n = 10）、未受累节段全椎间盘置换术（n = 3）、关节突螺钉固定术（n = 3）、关节突螺钉去除术（n = 1）和 L4-L5 椎间融合术（n = 1）。8 例（6.1%）再手术在指数水平。
单节段 AxiaLIF 是治疗症状性退行性椎间盘疾病患者腰骶融合的一种安全有效的方法。
