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类风湿关节炎合并腰椎退行性疾病患者行微创斜外侧腰椎椎间融合术的疗效

Outcomes of Minimally Invasive Oblique Lumbar Interbody Fusion in Patients with Lumbar Degenerative Disease with Rheumatoid Arthritis.

作者信息

Akbary Kutbuddin, Quillo-Olvera Javier, Lin Guang-Xun, Jo Hyun-Jin, Kim Jin-Sung

机构信息

Department of Neurosurgery, Seoul St. Mary's Hospital, Seoul, The Republic of Korea.

出版信息

J Neurol Surg A Cent Eur Neurosurg. 2019 May;80(3):162-168. doi: 10.1055/s-0038-1676301. Epub 2019 Jan 24.

Abstract

PURPOSE OF STUDY

Standard treatment protocols for lumbar degenerative lesions in the setting of rheumatoid arthritis (RA) are lacking. The purpose of this study was to evaluate the clinical and radiologic outcomes of minimally invasive oblique lumbar interbody fusion (MI-OLIF) in RA patients having degenerative lumbar spine lesions.

METHODS

This was a retrospective hospital-based case series (evidence level 4). Eight patients with degenerative lumbar disease with significant back pain and neurologic claudication underwent MI-OLIFwith polyetheretherketone cage insertion and posterior pedicle screw instrumentation. The clinical outcomes were measured by the numerical rating scale (NRS) for back and leg pain and the Oswestry Disability Index (ODI), and radiologic outcomes were studied on radiographs, computed tomography, and magnetic resonance imaging. Minimum follow-up duration was 1 year.

RESULTS

Mean NRS results for back and leg pain preoperatively were 6.3 and 7.1 that improved to 2.6 and 2 for back and leg pain, respectively, at last follow-up. The mean ODI scores preoperatively were 58.02 that improved to 39.06 at last follow-up. All patients had good functional outcomes, good fusion rates, and were able to continue their activities of daily living without much disability at last follow-up.

CONCLUSION

MI-OLIF in patients with symptomatic lumbar spine degenerative lesions with RA seems to provide good short-term clinical and radiologic outcomes.

摘要

研究目的

类风湿关节炎(RA)患者腰椎退行性病变缺乏标准治疗方案。本研究旨在评估微创斜外侧腰椎椎间融合术(MI-OLIF)治疗患有退行性腰椎病变的RA患者的临床和影像学结果。

方法

这是一项基于医院的回顾性病例系列研究(证据等级4)。8例患有严重背痛和神经源性间歇性跛行的退行性腰椎疾病患者接受了MI-OLIF手术,术中植入聚醚醚酮椎间融合器并进行后路椎弓根螺钉内固定。通过背部和腿部疼痛数字评定量表(NRS)以及奥斯威斯功能障碍指数(ODI)评估临床结果,并通过X线片、计算机断层扫描和磁共振成像研究影像学结果。最短随访时间为1年。

结果

术前背部和腿部疼痛的平均NRS结果分别为6.3和7.1,在最后一次随访时,背部和腿部疼痛分别改善至2.6和2。术前平均ODI评分为58.02,在最后一次随访时改善至39.06。所有患者在最后一次随访时均获得良好的功能结果、良好的融合率,并且能够继续进行日常生活活动,几乎没有残疾。

结论

对于有症状的腰椎退行性病变的RA患者,MI-OLIF似乎能提供良好的短期临床和影像学结果。

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