IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Eur Spine J. 2020 Feb;29(Suppl 1):6-13. doi: 10.1007/s00586-020-06303-z. Epub 2020 Jan 28.
Single-position options for combined anterior and posterior fusion in the lumbar spine have been suggested to reduce the surgical time and improve the efficiency of operating room. Previous reports have focused on lateral decubitus single-position surgery. The goal of this study is to describe and evaluate the feasibility and safety of prone single-position extreme lateral interbody fusion (XLIF) with posterior fixation.
Design Pilot prospective non-randomized controlled study. Seven patients who underwent prone single-position XLIF and posterior fixation were evaluated (Pro-XLIF). A control group (Std-XLIF) was composed of ten patients who underwent XLIF in lateral decubitus and posterior fixation in prone position. All patients underwent interbody XLIF fusion at one level and posterior procedures at one or more levels. Duration of surgery, blood loss, complications, X-ray use and clinical outcomes were recorded.
No major complications were observed in either group. Oswestry Disability Index, back pain and leg pain were improved in the Pro-XLIF group from 48.5, 7.7 and 8.5 to 14.5, 1.71 and 2.71, respectively, and in the Std-XLIF group from 50.8, 5.7 and 7.2 to 22.5, 3.7 and 2.5. The Pro-XLIF group had a longer time of preparation before incision (39 vs 26 min, ns), equal duration of the anterior procedure (65 vs 59 min, ns), shorter duration of surgery (133 vs 182 min, ns) and longer X-ray exposure time (102 vs 92 s, ns). The surgical technique is described.
Prone single-position XLIF is feasible and safe. In this preliminary report, the results are comparable to the standard technique. These slides can be retrieved under Electronic Supplementary Material.
在腰椎融合术中，人们提出了单一位置的选择方案，以减少手术时间并提高手术室的效率。先前的报告侧重于侧卧位单位置手术。本研究的目的是描述和评估后路固定下俯卧位单位置极外侧椎间融合术（XLIF）的可行性和安全性。
设计前瞻性非随机对照研究。评估了 7 例接受俯卧位单位置 XLIF 和后路固定的患者（Pro-XLIF）。对照组（Std-XLIF）由 10 例接受侧卧位 XLIF 和俯卧位后路固定的患者组成。所有患者均在一个节段进行椎间 XLIF 融合，在一个或多个节段进行后路手术。记录手术时间、失血量、并发症、X 线使用和临床结果。
两组均未观察到重大并发症。Pro-XLIF 组的 Oswestry 功能障碍指数、腰痛和腿痛分别从 48.5、7.7 和 8.5 改善至 14.5、1.71 和 2.71，而 Std-XLIF 组分别从 50.8、5.7 和 7.2 改善至 22.5、3.7 和 2.5。Pro-XLIF 组在切口前的准备时间较长（39 分钟 vs. 26 分钟，无统计学意义），前手术时间相等（65 分钟 vs. 59 分钟，无统计学意义），手术时间较短（133 分钟 vs. 182 分钟，无统计学意义），X 线暴露时间较长（102 秒 vs. 92 秒，无统计学意义）。描述了手术技术。
俯卧位单位置 XLIF 是可行且安全的。在本初步报告中，结果与标准技术相当。这些幻灯片可以在电子补充材料中检索到。
