Spine Research Center of Wannan Medical College, Department of Spine Surgery, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, China.
Spine Research Center of Wannan Medical College, Department of Spine Surgery, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, China.
World Neurosurg. 2020 Jan;133:e156-e164. doi: 10.1016/j.wneu.2019.08.158. Epub 2019 Aug 30.
To elucidate the correlation between changes in spinal/pelvic sagittal parameters and clinical treatment outcomes after oblique lumbar interbody fusion (OLIF).
Eighty-two patients with lumbar degenerative disease (LDD) treated by OLIF were retrospectively analyzed. The visual analog scale (VAS) score and Oswestry Disability Index (ODI) score were compared before and after surgery. Disk height (DH) and various spinal/pelvic sagittal parameters, including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), and sagittal vertical axis (SVA), were measured preoperatively and at the last postoperative follow-up. The correlation between the changes in sagittal parameters before and after surgery and the clinical treatment outcomes were observed.
ODI score, VAS score, and DH were significantly better at the last follow-up compared with before surgery. The change in PI was not statistically significant before and after surgery. PT significantly decreased and SS and LL significantly increased after surgery. Significant linear relationships were found for several independent variables (difference in DH before and after surgery, postoperative LL, difference in LL before and after surgery, PI-LL match status, and SVA status) and the dependent variable ODI. The difference in DH before and after surgery showed the strongest correlation. The percentages of PI-LL match were 37% before surgery and 66% after surgery. The percentage of the normal SVA was 9% before surgery and 62% after surgery.
OLIF for treatment of LDD had significant clinical outcomes, effectively restored the spinal/pelvic sagittal balance, and helped to improve the patients' clinical conditions.
阐明腰椎斜外侧融合术（OLIF）后脊柱/骨盆矢状参数变化与临床治疗效果的相关性。
回顾性分析 82 例腰椎退行性疾病（LDD）患者的 OLIF 治疗资料。比较手术前后视觉模拟评分（VAS）和 Oswestry 功能障碍指数（ODI）评分。测量术前和末次随访时的椎间盘高度（DH）和各种脊柱/骨盆矢状参数，包括骨盆入射角（PI）、骨盆倾斜角（PT）、骶骨倾斜角（SS）、腰椎前凸角（LL）和矢状垂直轴（SVA）。观察手术前后矢状参数变化与临床治疗效果的相关性。
末次随访时 ODI 评分、VAS 评分和 DH 均明显优于术前，手术前后 PI 变化无统计学意义，PT 明显降低，SS 和 LL 明显增加。几个自变量（手术前后 DH 差值、术后 LL、LL 前后差值、PI-LL 匹配状态和 SVA 状态）与因变量 ODI 之间存在显著线性关系。手术前后 DH 差值相关性最强。术前 PI-LL 匹配率为 37%，术后为 66%。术前 SVA 正常百分比为 9%，术后为 62%。
OLIF 治疗 LDD 具有显著的临床效果，有效恢复脊柱/骨盆矢状平衡，有助于改善患者的临床状况。
