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O型臂导航下单节段斜外侧腰椎椎间融合术与经皮椎弓根螺钉内固定术:一项回顾性对比研究

Single-Position Oblique Lumbar Interbody Fusion and Percutaneous Pedicle Screw Fixation under O-Arm Navigation: A Retrospective Comparative Study.

作者信息

Kim Hyung Cheol, Jeong Yeong Ha, Oh Sung Han, Lee Jong Min, Lee Chang Kyu, Yi Seong, Ha Yoon, Kim Keung Nyun, Shin Dong Ah

机构信息

Department of Neurosurgery, Bundang Jesaeng General Hospital, 20, Seohyeon-ro 180 beon-gil, Bundang-gu, Seongnam-si 13590, Republic of Korea.

Department of Neurosurgery, International St. Mary's Hospital, College of Medicine, Catholic Kwandong University, 25, Simgok-ro 100 gil, Seo-gu, Incheon 54671, Republic of Korea.

出版信息

J Clin Med. 2022 Dec 30;12(1):312. doi: 10.3390/jcm12010312.

Abstract

The insertion of pedicle screws in the lateral position without a position change has been reported. We completed a retrospective comparison of the radiologic and clinical outcomes of 36 patients who underwent either single-position oblique lateral lumbar interbody fusion (SP-OLIF) using the O-arm (36 cases) or conventional OLIF (C-OLIF) using the C-arm (20 cases) for L2-5 single-level lumbar degenerative diseases. Radiological parameters were analyzed, including screw accuracy (Gertzbein-Robbins classification system; GRS), segmental instability, and fusion status. Screw misplacement was defined as a discrepancy of ≥2 mm. Clinical outcomes, including visual analog scale, Oswestry Disability Index (ODI), 36-Item Short Form Health Survey (SF-36), and postoperative complications, were assessed. The spinal fusion rate was not different between the SP-OLIF and C-OLIF groups one year after surgery ( 0.536). The ODI score was lower ( 0.015) in the SP-OLIF than the C-OLIF group. Physical ( 0.000) and mental component summaries ( 0.000) of the SF-36 were significantly higher in the SP-OLIF group. Overall complication rates, including revision, surgical site infection, ipsilateral weakness, and radicular pain/numbness, were not significantly different. SP-OLIF using the O-arm procedure is feasible, with acceptable accuracy, fusion rate, and complication rate. This may be an alternative to conventional two-stage operations.

摘要

已有报道在侧卧位不改变体位的情况下植入椎弓根螺钉。我们对36例因L2 - 5单节段腰椎退行性疾病接受使用O型臂的单体位斜外侧腰椎椎间融合术(SP - OLIF,36例)或使用C型臂的传统斜外侧腰椎椎间融合术(C - OLIF,20例)的患者的影像学和临床结果进行了回顾性比较。分析了包括螺钉准确性(Gertzbein - Robbins分类系统;GRS)、节段性不稳定和融合状态在内的影像学参数。螺钉误置定义为偏差≥2 mm。评估了临床结果,包括视觉模拟评分、Oswestry功能障碍指数(ODI)、36项简明健康调查(SF - 36)以及术后并发症。术后1年,SP - OLIF组和C - OLIF组的脊柱融合率无差异(0.536)。SP - OLIF组的ODI评分低于C - OLIF组(0.015)。SP - OLIF组的SF - 36身体(0.000)和精神成分总结(0.000)显著更高。包括翻修、手术部位感染、同侧无力以及神经根性疼痛/麻木在内的总体并发症发生率无显著差异。使用O型臂手术的SP - OLIF是可行的,具有可接受的准确性、融合率和并发症发生率。这可能是传统两阶段手术的一种替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b77e/9821558/1529b36701a6/jcm-12-00312-g001.jpg

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