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单侧与双侧置钉单节段侧方腰椎间融合术的临床和影像学分析。

Clinical and radiographic analysis of unilateral versus bilateral instrumented one-level lateral lumbar interbody fusion.

机构信息

Inanami Spine and Joint Hospital, Tokyo, Japan.

Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan.

出版信息

Sci Rep. 2020 Feb 20;10(1):3105. doi: 10.1038/s41598-020-59706-9.

Abstract

Lateral lumbar interbody fusion (LLIF) is a widely applied and useful procedure for spinal surgeries. However, posterior fixation has not yet been decided. We compared the radiographic and clinical outcomes of unilateral versus bilateral instrumented one-level LLIF for degenerative lumbar disease. We conducted a prospective cohort study of 100 patients, who underwent unilateral (group U) or bilateral (group B) instrumented one-level LLIF for degenerative lumbar disease. Forty-one patients in group U were undergoing unilateral pedicle screw instrumentation, and 59 patients in group B were undergoing bilateral pedicle screw instrumentation. Clinical characteristic and demographic data before surgery were compared. The intraoperative data, including operative time with changes in positions, intraoperative blood loss, and X-ray exposure time, as well as the perioperative data, including postoperative hospital stay and clinical and radiographic data were compared. As a result, Group U required a significantly shorter operating time than group B. The subsidence grade and fusion rates exhibited no significant differences in the postoperative radiographic evaluation. Group U had better results in clinical assessments than group B. However, group U required more additional surgeries owing to complications.

摘要

腰椎侧方融合术(LLIF)是一种广泛应用且有效的脊柱手术方法。然而,对于后方固定方式仍未达成共识。我们比较了单侧与双侧固定单节段 LLIF 治疗退变性腰椎疾病的影像学和临床结果。我们对 100 例退变性腰椎疾病患者进行了前瞻性队列研究,这些患者接受了单侧(U 组)或双侧(B 组)固定单节段 LLIF 治疗。U 组中有 41 例患者接受单侧经皮椎弓根螺钉固定,B 组中有 59 例患者接受双侧经皮椎弓根螺钉固定。比较了手术前的临床特征和人口统计学数据。比较了术中数据,包括手术体位改变时间、术中失血量和 X 射线曝光时间,以及围手术期数据,包括术后住院时间和临床及影像学数据。结果显示,U 组的手术时间明显短于 B 组。术后影像学评估中,两组的沉降程度和融合率无显著差异。U 组在临床评估中的结果优于 B 组。然而,U 组由于并发症需要更多的额外手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c198/7033185/7ee22fc00714/41598_2020_59706_Fig1_HTML.jpg

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