Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Neurosurgery. 2023 Jul 1;93(1):60-65. doi: 10.1227/neu.0000000000002371. Epub 2023 Feb 9.
The long-term durability of stand-alone lateral lumbar interbody fusion (LLIF) remains unknown.
To evaluate whether early patient-reported outcome measures after stand-alone LLIF are sustained on long-term follow-up.
One hundred and twenty-six patients who underwent stand-alone LLIF between 2009 and 2017 were included in this study. Patient-reported outcome measures included the Oswestry Disability Index (ODI), EuroQOL-5D (EQ-5D), and visual analog score (VAS) scores. Durable outcomes were defined as scores showing a significant improvement between preoperative and 6-week scores without demonstrating any significant decline at future time points. A repeated measures analysis was conducted using generalized estimating equations (model) to assess the outcome across different postoperative time points, including 6 weeks, 1 year, 2 years, and 5 years.
ODI scores showed durable improvement at 5-year follow-up, with scores improving from 46.9 to 38.5 ( P = .001). Improvements in EQ-5D showed similar durability up to 5 years, improving from 0.48 to 0.65 ( P = .03). VAS scores also demonstrated significant improvements postoperatively that were durable at 2-year follow-up, improving from 7.0 to 4.6 ( P < .0001).
Patients undergoing stand-alone LLIF were found to have significant improvements in ODI and EQ-5D at 6-week follow-up that remained durable up to 5 years postoperatively. VAS scores were found to be significantly improved at 6 weeks and up to 2 years postoperatively but failed to reach significance at 5 years. These findings demonstrate that patients undergoing stand-alone LLIF show significant improvement in overall disability after surgery that remains durable at long-term follow-up.
单纯侧路腰椎间融合术（LLIF）的长期耐久性尚不清楚。
评估单纯 LLIF 后早期患者报告的结局测量指标是否在长期随访中得以维持。
本研究纳入了 2009 年至 2017 年间接受单纯 LLIF 的 126 例患者。患者报告的结局测量包括 Oswestry 功能障碍指数（ODI）、欧洲五维健康量表（EQ-5D）和视觉模拟评分（VAS）。耐用性结果定义为术前和 6 周评分之间存在显著改善，且在未来时间点没有任何显著下降。使用广义估计方程（模型）进行重复测量分析，以评估不同术后时间点的结果，包括 6 周、1 年、2 年和 5 年。
ODI 评分在 5 年随访时显示出持久的改善，从 46.9 分改善至 38.5 分（P=0.001）。EQ-5D 的改善表现出类似的耐久性，从 0.48 提高至 0.65（P=0.03）。VAS 评分也显示出显著的术后改善，在 2 年随访时仍具有耐久性，从 7.0 分改善至 4.6 分（P<0.0001）。
接受单纯 LLIF 的患者在 6 周随访时 ODI 和 EQ-5D 显著改善，术后 5 年仍保持耐久性。VAS 评分在 6 周和 2 年随访时显著改善，但在 5 年随访时未达到显著水平。这些发现表明，接受单纯 LLIF 的患者在手术后整体残疾方面有显著改善，且在长期随访中保持耐久性。
