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斜外侧椎间融合技术在挽救性手术中的应用:技术说明与病例系列

Application of the oblique lateral interbody fusion technique in salvage surgery: technical note and case series.

作者信息

Han Jialuo, Han Shuo, Meng Shengwei, Zhao Xiaodan, Zhang Hao, Guo Jianwei, Xu Derong, Liu Houchen, Chen Mingrui, Ma Xuexiao, Wang Yan

机构信息

Department of Spine Surgery, The Affiliated Hospital of Qingdao University, Shandong, China.

Department of Radiology, The Affiliated Hospital of Qingdao University, Shandong, China.

出版信息

Front Surg. 2023 May 19;10:1144699. doi: 10.3389/fsurg.2023.1144699. eCollection 2023.

Abstract

OBJECTIVE

The oblique lateral interbody fusion (OLIF) technique is a promising interbody fusion technique. This study summarizes the technical aspects of OLIF as a salvage surgery and the preliminary outcomes of a series of cases.

PATIENTS AND METHODS

A retrospective review of patients with leg or back pain induced by pseudoarthrosis or adjacent segment disease after posterior lumbar interbody fusion/transforaminal lumbar interbody fusion was done. These patients underwent salvage OLIF surgeries in our institution from January 2021 to March 2022. Variables such as the demographic, clinical, surgical, and radiological characteristics of the enrolled patients were recorded and analyzed.

RESULTS

Eight patients (five females and three males; mean age 69.1 ± 5.7 years, range 63-80 years) were enrolled in this study. The mean operative time was 286.25 min (range: 230-440 min), and the estimated blood loss was 90 ml (range: 50-150 ml). Only one of the eight patients experienced a complication of lower limb motor weakness, which disappeared within 5 days after surgery. The latest data showed that the mean intervertebral space height increased from 8.36 mm preoperatively to 12.70 mm and the mean segmentary lordosis increased from 8.92° preoperatively to 15.05°. Bone fusion was achieved in all but one patient, who was followed up for only 3 months. The JOA scores Japanese Orthopaedic Association (JOA) Scores for low back pain of all patients significantly improved at the final follow-up.

CONCLUSION

OLIF provides a safe and effective salvage strategy for patients with failed posterior intervertebral fusion surgery. Patients effectively recovered intervertebral and foraminal height with no additional posterior direct decompression.

摘要

目的

斜外侧椎间融合(OLIF)技术是一种很有前景的椎间融合技术。本研究总结了OLIF作为挽救性手术的技术要点以及一系列病例的初步结果。

患者与方法

对因后路腰椎椎间融合术/经椎间孔腰椎椎间融合术后假关节形成或相邻节段疾病导致腿痛或背痛的患者进行回顾性研究。这些患者于2021年1月至2022年3月在本机构接受了挽救性OLIF手术。记录并分析了纳入患者的人口统计学、临床、手术和放射学特征等变量。

结果

本研究纳入了8例患者(5例女性和3例男性;平均年龄69.1±5.7岁,范围63 - 80岁)。平均手术时间为286.25分钟(范围:230 - 440分钟),估计失血量为90毫升(范围:50 - 150毫升)。8例患者中只有1例出现下肢运动无力并发症,术后5天内消失。最新数据显示,平均椎间隙高度从术前的8.36毫米增加到12.70毫米,平均节段前凸从术前的8.92°增加到15.05°。除1例仅随访3个月的患者外,所有患者均实现了骨融合。所有患者的日本矫形外科学会(JOA)下腰痛评分在末次随访时均显著改善。

结论

OLIF为后路椎间融合手术失败的患者提供了一种安全有效的挽救策略。患者有效地恢复了椎间隙和椎间孔高度,无需额外的后路直接减压。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2f8/10235443/84f8ae543703/fsurg-10-1144699-g001.jpg

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