Department of Spine Surgery, Xi'an Jiaotong University Affiliated Honghui Hospital, Xi'an, 710000, Shaanxi, China.
J Orthop Surg Res. 2022 Feb 21;17(1):115. doi: 10.1186/s13018-022-02991-z.
To observe the clinical efficacy of an anterior single rob-screw fixation (ASRSF) combined with the oblique lumbar intervertebral fusion (OLIF) approach compared with a posterior percutaneous screw fixation (PPSF) combined with OLIF in the treatment of lumbar spondylolisthesis.
This is a retrospective case-control study. Patients with degenerative lumbar spondylolisthesis (DLS) treated with either ASRSF combined with OLIF or PPSF combined with OLIF from January 2016 to January 2018 were enrolled in this study. None of the patients had posterior decompression. The visual analog scale (VAS) and Oswestry dysfunction index (ODI) were used for clinical efficacy assessment. The pre- and post-operational disc height, height of foramen, subsidence, and migration of cages, fusion rate and surgery-related complications were compared between the two groups.
Fifty-three patients were included in this single-center study. According to the fixation methods, patients were divided into the ASRSF group (group A, 25 cases) and the PPSF group (group B, 28 cases). There was no statistical difference in surgery-related complications between groups. There was a significant difference in the VAS score at one-week post-surgery (2.3 ± 0.5 vs. 3.5 ± 0.4, P = 0.01), and three months post-operation (2.2 ± 0.3 vs. 3.0 ± 0.3, P = 0.01). Comparison of post-operative imaging data showed that there was a significant difference in the height of the foramen between groups at three months post-surgery(18.1 ± 2.3 mm vs. 16.9 ± 1.9 mm, P = 0.04). At 24 months post-surgery, the ODI was 12.65 ± 3.6 in group A and 19.1 ± 3.4 in group B (P = 0.01). Twelve months after surgery, the fusion rate in group A at 72.0% and 78.6% in group B was not statistically significant (P = 0.75). Fusion was identified in all patients at 24 months post-surgery.
When compared to PPSF, ASRSF combined with OLIF for DLS can reduce post-operative low back pain in the initial stages, maintain the height of the foramen and improve the performance of lumbar function.
观察经前路单枚螺钉固定（ASRSF）联合斜侧入路椎间融合术（OLIF）与后路经皮螺钉固定（PPSF）联合 OLIF 治疗腰椎滑脱症的临床疗效。
这是一项回顾性病例对照研究。纳入 2016 年 1 月至 2018 年 1 月采用 ASRSF 联合 OLIF 或 PPSF 联合 OLIF 治疗退行性腰椎滑脱症（DLS）的患者。两组患者均未行后路减压。采用视觉模拟评分（VAS）和 Oswestry 功能障碍指数（ODI）评估临床疗效。比较两组患者术前、术后椎间隙高度、椎间孔高度、内固定下沉和移位、融合率及手术相关并发症。
本单中心研究共纳入 53 例患者。根据固定方式分为前路螺钉固定组（A 组，25 例）和后路经皮螺钉固定组（B 组，28 例）。两组患者手术相关并发症发生率比较，差异无统计学意义。术后 1 周 VAS 评分（2.3±0.5 比 3.5±0.4，P=0.01）及术后 3 个月 VAS 评分（2.2±0.3 比 3.0±0.3，P=0.01）比较，差异有统计学意义。术后影像学资料比较，两组患者术后 3 个月椎间孔高度比较，差异有统计学意义（18.1±2.3mm 比 16.9±1.9mm，P=0.04）。术后 24 个月时，A 组 ODI 为 12.65±3.6，B 组为 19.1±3.4（P=0.01）。术后 12 个月时，A 组融合率为 72.0%，B 组为 78.6%，差异无统计学意义（P=0.75）。术后 24 个月时所有患者均融合。
与 PPSF 相比，ASRSF 联合 OLIF 治疗 DLS 可减少术后早期腰痛，维持椎间孔高度，改善腰椎功能。
