Wu Meng-Ting, Chung Tzu-Tsao, Chen Shao-Ching, Kao Tzu-Jen, Song Wen-Shin
Division of Neurosurgery, Department of Surgery, Cheng-Hsin General Hospital, Taipei, Taiwan.
Ph.D. Program of Electrical and Communications Engineering, Feng Chia University, Taichung City, Taiwan.
Front Surg. 2022 Dec 26;9:989372. doi: 10.3389/fsurg.2022.989372. eCollection 2022.
Oblique lateral interbody fusion (OLIF) is a type of minimally invasive lateral lumbar interbody fusion technique used for treating lumbar degenerative diseases. This study aimed to analyze the clinical and radiographic efficacy of OLIF with anterolateral screw fixation alone and OLIF requiring fixation with conventional posterior percutaneous pedicle screws for lumbar diseases.
Medical records of consecutive patients admitted to Cheng-Hsin Hospital who received OLIF between January 2019 and December 2020 were retrospectively reviewed. Patients were divided into two groups by screw fixation: patients who received anterolateral screw fixation alone were defined as one-stage OLIF ( = 9) and patients who received fixation with conventional posterior percutaneous pedicle screw were defined as two-stage OLIF ( = 16). Patient clinical characteristics, medical history, intraoperative blood loss, length of hospital stay, peri-operative, and post-operative complications were evaluated in all patients.
During the study period, a total of 25 patients were successfully treated with OLIF ( = 9 one-stage; = 16 two-stage). Two-stage OLIF was associated with longer operation times, longer hospital stays, shorter bed-rest time, and a greater likelihood of having a blood transfusion compared with the one-stage OLIF group. A higher proportion of grade I subsidence was observed at 6 months and 1 year after surgery in the two-stage group compared with the one-stage group. Post-operative complications included ileus, dystonia, and dystonia were higher in the two-stage OLIF group. Improvements in radiographic parameters were demonstrated after OLIF, and the improvements were comparable between one-stage and two-stage OLIF.
One-stage OLIF is a feasible and efficacious treatment method for single- and multiple-level degenerative lumbar diseases. Additional clinical follow-up is necessary to confirm long-term outcomes.
斜外侧椎间融合术（OLIF）是一种用于治疗腰椎退行性疾病的微创外侧腰椎椎间融合技术。本研究旨在分析单纯前路螺钉固定的OLIF与需用传统后路经皮椎弓根螺钉固定的OLIF治疗腰椎疾病的临床和影像学疗效。
回顾性分析2019年1月至2020年12月在成信医院接受OLIF治疗的连续患者的病历。根据螺钉固定方式将患者分为两组：单纯接受前路螺钉固定的患者定义为一期OLIF（n = 9），接受传统后路经皮椎弓根螺钉固定的患者定义为二期OLIF（n = 16）。评估所有患者的临床特征、病史、术中出血量、住院时间、围手术期和术后并发症。
在研究期间，共有25例患者成功接受了OLIF治疗（9例一期；16例二期）。与一期OLIF组相比，二期OLIF的手术时间更长、住院时间更长、卧床休息时间更短且输血可能性更大。与一期组相比，二期组在术后6个月和1年观察到I级沉降的比例更高。二期OLIF组术后并发症包括肠梗阻、肌张力障碍，肌张力障碍发生率更高。OLIF术后影像学参数有改善，一期和二期OLIF的改善情况相当。
一期OLIF是治疗单节段和多节段退行性腰椎疾病的一种可行且有效的治疗方法。需要进一步的临床随访以确认长期疗效。
