Department of Orthopedics, Anqing Municipal Hospital, Anqing, Anhui, PR China.
Eur Rev Med Pharmacol Sci. 2022 Nov;26(21):7960-7966. doi: 10.26355/eurrev_202211_30148.
To investigate the correlation between scoliosis direction and oblique lateral lumbar interbody fusion (OLIF) operation channel angle in patients with degenerative lumbar scoliosis.
80 cases of degenerative lumbar scoliosis and 40 cases of lumbar degenerative diseases without scoliosis were retrospectively studied in our hospital from January 2018 to January 2021. The general data and imaging indexes of all patients were analyzed, and the correlation between the rotation angle of vertebral body and the channel angle of OLIF operation was evaluated.
The distance between abdominal aorta and psoas muscle in L2-3 and L3-4 segments, and the distance between abdominal aorta and lumbar sympathetic trunk in L3-4 segments, as well as the angles of OLIF operation channels in L2-3, L3-4 and L4-5 segments of the right-scoliosis group were all significantly greater than those in the no-scoliosis group (p < 0.05). The distance between abdominal aorta and lumbar sympathetic trunk in L4-5 segments of the left-scoliosis group was significantly greater than that in the no-scoliosis group and the right-scoliosis group (p < 0.05). The angle of OLIF operation channel in L3-4 and L4-5 segments of the left-scoliosis group was significantly smaller than that in the non-scoliosis group (p < 0.05), and the distance between psoas major and transverse axis of vertebral body in L2-3 and L3-4 segments of the left-scoliosis group was significantly greater than that in the non-scoliosis group (p < 0.05). The distance between adjacent vertebral bodies in L2-3 and L3-4 segments of the right-scoliosis group was significantly larger than that in the non-scoliosis group (p < 0.05). The distance between psoas major and transverse axis of vertebral body in L4-5 segment of the left-scoliosis group was significantly larger than that in the no-scoliosis group and the right-scoliosis group (p < 0.05). Correlation analysis showed that there was a negative correlation between OLIF operation channel angle and vertebral rotation angle in the left scoliosis group (p < 0.05), and a positive correlation between OLIF operation channel angle and vertebral rotation angle in the right scoliosis group (p < 0.05).
The scoliosis direction of patients with degenerative lumbar scoliosis can directly affect the angle of OLIF operation channel, so targeted design and operation adjustment should be given according to the scoliosis direction of patients before operation.
探讨退变性腰椎侧凸患者脊柱侧凸方向与斜外侧腰椎间融合术(OLIF)手术入路角度的相关性。
回顾性分析我院 2018 年 1 月至 2021 年 1 月收治的 80 例退变性腰椎侧凸患者和 40 例无脊柱侧凸的腰椎退行性疾病患者的临床资料,分析所有患者的一般资料和影像学指标,评估椎体旋转角度与 OLIF 手术入路角度的相关性。
右侧脊柱侧凸组 L2-3 和 L3-4 节段腹主动脉与腰大肌、L3-4 节段腹主动脉与腰交感干的距离,L2-3、L3-4 和 L4-5 节段 OLIF 手术通道角度均明显大于无脊柱侧凸组(p<0.05);左侧脊柱侧凸组 L4-5 节段腹主动脉与腰交感干的距离明显大于无脊柱侧凸组和右侧脊柱侧凸组(p<0.05);左侧脊柱侧凸组 L3-4 和 L4-5 节段 OLIF 手术通道角度明显小于无脊柱侧凸组(p<0.05),L2-3 和 L3-4 节段腰大肌与椎体横轴的距离明显大于无脊柱侧凸组(p<0.05);右侧脊柱侧凸组 L2-3 和 L3-4 节段相邻椎体之间的距离明显大于无脊柱侧凸组(p<0.05);左侧脊柱侧凸组 L4-5 节段腰大肌与椎体横轴的距离明显大于无脊柱侧凸组和右侧脊柱侧凸组(p<0.05)。相关性分析显示,左侧脊柱侧凸组 OLIF 手术通道角度与椎体旋转角度呈负相关(p<0.05),右侧脊柱侧凸组 OLIF 手术通道角度与椎体旋转角度呈正相关(p<0.05)。
退变性腰椎侧凸患者的脊柱侧凸方向可直接影响 OLIF 手术通道角度,术前应根据患者脊柱侧凸方向进行针对性设计和手术调整。