Department of Neurosurgery, Xuanwu Hospital of Capital Medical University, 100053, China.
Biomed Res Int. 2019 Jan 8;2019:5672162. doi: 10.1155/2019/5672162. eCollection 2019.
The authors recently used a combination of minimally invasive oblique lumbar interbody fusion (OLIF) and lateral fixation for the treatment of degenerative spine deformity. The early results were promising. Radiographic and clinical results as well as complications were retrospectively assessed in the current study.
Eleven patients with degenerative spine deformity underwent combined OLIF and lateral instrumentation without real-time electromyography (EMG) monitoring. Radiographic measurements including coronal Cobb angle, central sacral vertebral line (CSVL), lumbar lordosis (LL), sagittal vertebral axis (SVA), pelvic tilt (PT), and LL-PI (pelvic incidence) mismatch were taken preoperatively and at last follow-up postoperatively in all patients. Concurrently, the visual analog score (VAS) for back pain and the Oswestry Disability Index (ODI) score were used to assess clinical outcomes. The fusion rate of OLIF cage, total blood loss, operation time, hospital stay, and complications were also evaluated.
At last follow-up, all patients who underwent combined OLIF and lateral instrumentation achieved statistically significant improvement in coronal Cobb angle (from 15.3±4.7° to 5.9±3.1°, p < 0.01), LL (from 34.3±9.0° to 48.2±8.5°, p < 0.01), PT (from 24.2±9.6° to 16.2±6.0°, p < 0.01), LL-PI mismatch (from 15.4±8.7° to 7.0±3.7°, p < 0.01), CSVL (from 2.1±2.2cm to 0.7±0.9cm, p = 0.01), and SVA (from 7.0±3.9cm to 2.9±1.8cm, p < 0.01). VAS for back pain (from 6.9±1.4 to 2.0±0.9, p < 0.05) and ODI (from 39.5±3.1 to 21.9±3.6, p < 0.01) improved significantly after surgery.
A combination of OLIF and lateral instrumentation is an effective and safety means of achieving correction of both coronal and sagittal deformity, resulting in improvement of quality of life in patients with degenerative spine deformity. It is a promising way to treat patients with moderate degenerative spine deformity.
作者近期采用微创斜侧腰椎体间融合术（OLIF）联合侧方固定治疗退行性脊柱畸形，取得了较好的早期结果。本研究回顾性评估了影像学和临床结果及并发症。
11 例退行性脊柱畸形患者行单纯 OLIF 联合侧方内固定术，未行实时肌电图（EMG）监测。所有患者均于术前及末次随访时进行影像学测量，包括冠状面 Cobb 角、正中骶骨椎体线（CSVL）、腰椎前凸角（LL）、矢状面椎体轴（SVA）、骨盆倾斜角（PT）和骨盆入射角（PI）不匹配；同时采用视觉模拟评分（VAS）评估腰痛，用 Oswestry 功能障碍指数（ODI）评分评估临床结果。还评估了 OLIF 融合器的融合率、总失血量、手术时间、住院时间和并发症。
末次随访时，所有接受 OLIF 联合侧方固定的患者，冠状面 Cobb 角（从 15.3±4.7°变为 5.9±3.1°，p＜0.01）、LL（从 34.3±9.0°变为 48.2±8.5°，p＜0.01）、PT（从 24.2±9.6°变为 16.2±6.0°，p＜0.01）、LL-PI 不匹配（从 15.4±8.7°变为 7.0±3.7°，p＜0.01）、CSVL（从 2.1±2.2cm 变为 0.7±0.9cm，p=0.01）和 SVA（从 7.0±3.9cm 变为 2.9±1.8cm，p＜0.01）均有统计学显著改善。腰痛的 VAS（从 6.9±1.4 变为 2.0±0.9，p＜0.05）和 ODI（从 39.5±3.1 变为 21.9±3.6，p＜0.01）评分术后显著改善。
OLIF 联合侧方固定是一种有效、安全的矫正冠状面和矢状面畸形的方法，可改善退行性脊柱畸形患者的生活质量。对于中度退行性脊柱畸形患者，这是一种有前途的治疗方法。
