Ningxia Medical University, Yinchuan, China.
Department of Orthopedics, General Hospital of Ningxia Medical University, Yinchuan, China.
Orthop Surg. 2021 Jun;13(4):1181-1190. doi: 10.1111/os.12960. Epub 2021 May 4.
To evaluate the clinical outcomes of oblique lumbar interbody fusion (OLIF) in conjunction with unilateral pedicle screw fixation (UPSF) via the Wiltse approach in treating degenerative lumbar scoliosis (DLS).
The article is a retrospective analysis. Twelve patients with DLS who underwent combined OLIF and UPSF between July 2017 and December 2018 were included. The study included 2 male and 10 female patients, with a mean age at the time of the operation of 67.2 ± 9.1 years. The surgical characteristics and complications were evaluated. The clinical and radiological data such as the correction of deformity, coronal and sagittal profile were analyzed.
The mean follow-up time of the study was 26.8 ± 1.8 months. At the final follow-up, all patients who underwent combined OLIF and UPSF achieved statistically significant improvements in coronal Cobb angle (from 19.6° ± 4.8° to 6.9° ± 3.8°, P < 0.01), distance between the C7 plumb line and central sacral vertebral line (from 2.5 ± 1.7 cm to 0.9 ± 0.6 cm, P < 0.01), sagittal vertebral axis (from 4.3 ± 4.3 cm to 1.5 ± 1.0 cm, P = 0.03), lumbar lordosis (from 29.4° ± 8.6° to 40.8° ± 5.8°, P < 0.01), pelvic tilt (from 27.6° ± 10.8° to 18.3° ± 7.0°, P < 0.01), pelvic incidence-lumbar lordosis mismatch (from 23.3° ± 10.5° to 11.9° ± 8.4°, P < 0.01), and cross-sectional area of the dural sac (from 87.33 ± 39.41 mm to 124.70 ± 39.26 mm , P < 0.01). The visual analogue score for back and leg pain and Oswestry Disability Index of all patients significantly improved postoperatively (P < 0.01). One case of lumbar plexus injury was found after surgery. During the follow-up period, one patient had cage subsidence. A fusion rate of 100% and good positioning of the pedicle screws were achieved in all patients at the final follow-up.
OLIF in conjunction with UPSF is a safe and effective minimally invasive procedure for correcting both coronal and sagittal deformities, as it results in an improved quality of life in patients with DLS.
评估经 Wiltse 入路斜侧腰椎体间融合术（OLIF）联合单侧经皮椎弓根螺钉固定术（UPSF）治疗退行性腰椎侧凸（DLS）的临床疗效。
这是一项回顾性分析。2017 年 7 月至 2018 年 12 月，12 例 DLS 患者接受了联合 OLIF 和 UPSF 治疗。研究包括 2 例男性和 10 例女性患者，手术时的平均年龄为 67.2±9.1 岁。评估了手术特点和并发症。分析了临床和影像学数据，如畸形矫正、冠状面和矢状面轮廓。
研究的平均随访时间为 26.8±1.8 个月。末次随访时，所有接受联合 OLIF 和 UPSF 治疗的患者在冠状面 Cobb 角（从 19.6°±4.8°到 6.9°±3.8°，P<0.01）、C7 铅垂线与中矢状线距离（从 2.5±1.7cm 到 0.9±0.6cm，P<0.01）、矢状位脊柱轴（从 4.3±4.3cm 到 1.5±1.0cm，P=0.03）、腰椎前凸角（从 29.4°±8.6°到 40.8°±5.8°，P<0.01）、骨盆倾斜角（从 27.6°±10.8°到 18.3°±7.0°，P<0.01）、骨盆入射角-腰椎前凸角不匹配（从 23.3°±10.5°到 11.9°±8.4°，P<0.01）和硬脊膜囊横截面积（从 87.33±39.41mm 到 124.70±39.26mm，P<0.01）方面均取得了统计学显著改善。所有患者的腰痛和腿痛视觉模拟评分以及 Oswestry 功能障碍指数均在术后显著改善（P<0.01）。术后发现 1 例腰椎丛损伤。随访期间，1 例患者出现 cage 沉降。所有患者在末次随访时均达到 100%的融合率和良好的椎弓根螺钉定位。
经 Wiltse 入路 OLIF 联合 UPSF 是一种安全有效的微创手术，可矫正冠状面和矢状面畸形，改善退行性腰椎侧凸患者的生活质量。
