Tan Ying, Tanaka Masato, Sonawane Sumeet, Uotani Koji, Oda Yoshiaki, Fujiwara Yoshihiro, Arataki Shinya, Yamauchi Taro, Takigawa Tomoyuki, Ito Yasuo
Department of Orthopaedic Surgery, Okayama Rosai Hospital, Okayama 702-8055, Japan.
Department of Spinal Surgery, Weifang Traditional Chinese Medicine Hospital, Weifang 261041, China.
J Clin Med. 2021 Oct 26;10(21):4938. doi: 10.3390/jcm10214938.
Minimally invasive posterior or transforaminal lumbar interbody fusion (MI-PLIF/TLIF) are widely accepted procedures for lumbar instability due to degenerative or traumatic diseases. Oblique lateral interbody fusion (OLIF) is currently receiving considerable attention because of the reductions in damage to the back muscles and neural tissue. The aim of this study was to compare clinical and radiographic outcomes of simultaneous single-position OLIF and percutaneous pedicle screw (PPS) fixation with MI-PLIF/TLIF. This retrospective comparative study included 98 patients, comprising 63 patients with single-position OLIF (Group SO) and 35 patients with MI-PLIF/TLIF (Group P/T). Cases with more than 1 year of follow-up were included in this study. Mean follow-up was 32.9 ± 7.0 months for Group SO and 33.7 ± 7.5 months for Group P/T. Clinical and radiological evaluations were performed. Comparing Group SO to Group P/T, surgical time and blood loss were 118 versus 172 min ( < 0.01) and 139 versus 374 mL ( < 0.01), respectively. Cage height, change in disk height, and postoperative foraminal height were significantly higher in Group SO than in Group P/T. The fusion rate was 96.8% in Group SO, similar to the 94.2% in Group P/T ( = 0.985). The complication rate was 6.3% in Group SO and 14.1% in Group P/T ( = 0.191). Simultaneous single position O-arm-navigated OLIF reduces the surgical time, blood loss, and time to ambulation after surgery. Good indirect decompression can be achieved with this method.
微创后路或经椎间孔腰椎椎间融合术(MI-PLIF/TLIF)是治疗因退行性或创伤性疾病导致腰椎不稳的广泛接受的手术方法。斜外侧椎间融合术(OLIF)由于对背部肌肉和神经组织的损伤较小,目前受到了广泛关注。本研究的目的是比较同期单节段OLIF联合经皮椎弓根螺钉(PPS)固定与MI-PLIF/TLIF的临床和影像学结果。这项回顾性比较研究纳入了98例患者,其中63例接受单节段OLIF(SO组),35例接受MI-PLIF/TLIF(P/T组)。本研究纳入了随访超过1年的病例。SO组的平均随访时间为32.9±7.0个月,P/T组为33.7±7.5个月。进行了临床和影像学评估。将SO组与P/T组进行比较,手术时间和失血量分别为118分钟对172分钟(<0.01)和139毫升对374毫升(<0.01)。SO组的椎间融合器高度、椎间隙高度变化和术后椎间孔高度显著高于P/T组。SO组的融合率为96.8%,与P/T组的94.2%相似(=0.985)。SO组的并发症发生率为6.3%,P/T组为14.1%(=0.191)。同期单节段O型臂导航OLIF可减少手术时间、失血量和术后下床活动时间。该方法可实现良好的间接减压。