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使用聚醚醚酮椎间融合器的微创斜外侧腰椎椎间融合术治疗腰椎化脓性脊柱炎的疗效

Efficacy of Minimally Invasive Oblique Lumbar Interbody Fusion Using Polyetheretherketone Cages for Lumbar Pyogenic Spondylodiscitis Treatment.

作者信息

Bae Jong-Woo, Lee Sang-Soo, Yang Jae-Shin, Seo Eun-Min

机构信息

Department of Orthopedic Surgery, Chungju Hospital, Konkuk University School of Medicine, Chungju 27428, Republic of Korea.

Department of Orthopedic Surgery, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon 23253, Republic of Korea.

出版信息

J Pers Med. 2023 Aug 24;13(9):1293. doi: 10.3390/jpm13091293.

Abstract

(1) Background: This study evaluated the efficacy and safety of a minimally invasive oblique lumbar interbody fusion (OLIF) using polyetheretherketone (PEEK) cages for the treatment of lumbar pyogenic spondylodiscitis. (2) Methods: Fifty-one patients with single-level lumbar pyogenic spondylodiscitis were included in the study. Patients were divided into two groups: anterior lumbar interbody fusion with a tri-cortical iliac bone graft (ALIF+ tri-cortical iliac bone graft) (n = 28) and OLIF using PEEK cages with an autologous bone graft (OLIF+ PEEK cages) (n = 23). Perioperative radiographic parameters, complications, and clinical outcomes in both groups were analyzed and compared. (3) Results: The postoperative and final follow-up LL (lumbar lordosis) and RL (regional lordosis) were improved in both groups ( < 0.001). But, compared with the ALIF group, the OLIF group had more improvement of the RL. The operation time was 79 min for the OLIF group and 101 min for the ALIF group ( < 0.05). The intraoperative blood loss was 92 mL for the OLIF group and 114 mL for the ALIF group ( < 0.05). Significant clinical improvement was observed in visual analogue scale scores for the back and Oswestry Disability Index in both groups ( < 0.001). There was no recurrence of infection. (4) Conclusions: Compared with the ALIF group, the OLIF group had more improvement in radiographic and clinical outcomes. Thus, OLIF using PEEK cages with an autologous bone graft could be proposed for the surgical treatment of lumbar pyogenic spondylodiscitis.

摘要

(1)背景:本研究评估了使用聚醚醚酮(PEEK)椎间融合器的微创斜外侧腰椎椎间融合术(OLIF)治疗腰椎化脓性脊柱炎的疗效和安全性。(2)方法:本研究纳入了51例单节段腰椎化脓性脊柱炎患者。患者分为两组:前路腰椎椎间融合术加三面皮质髂骨移植(ALIF + 三面皮质髂骨移植)(n = 28)和使用PEEK椎间融合器加自体骨移植的OLIF(OLIF + PEEK椎间融合器)(n = 23)。分析并比较两组的围手术期影像学参数、并发症和临床结果。(3)结果:两组术后及末次随访时的腰椎前凸(LL)和节段性前凸(RL)均得到改善(<0.001)。但是,与ALIF组相比,OLIF组的RL改善更多。OLIF组的手术时间为79分钟,ALIF组为101分钟(<0.05)。OLIF组术中出血量为92毫升,ALIF组为114毫升(<0.05)。两组的背部视觉模拟评分和Oswestry功能障碍指数均有显著的临床改善(<0.001)。感染无复发。(4)结论:与ALIF组相比,OLIF组在影像学和临床结果方面改善更多。因此,使用PEEK椎间融合器加自体骨移植的OLIF可用于腰椎化脓性脊柱炎的手术治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef4a/10532636/ac6a339bc7da/jpm-13-01293-g001.jpg

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