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斜外侧椎间融合术(OLIF)与微创经椎间孔椎间融合术(MIS-TLIF)治疗成人退变性腰椎侧凸的疗效比较。

Comparison of the effects between oblique lateral interbody fusion (OLIF) and minimally invasive transforaminal interbody fusion (MIS-TLIF) in the treatment of adult degenerative lumbar scoliosis.

作者信息

Jun Li, Zou Tao, Wei Jia J, Huo Tianqun, Min Wen, Wei Chengjian, Zhao Hong

机构信息

Changzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Department of Spine Surgery, Changzhou 213000, PR China.

Yunnan Province Hospital of Traditional Chinese Medicine, Departmen of Orthopedics, Kunming 650000, PR China.

出版信息

J Orthop. 2024 Jun 26;58:58-65. doi: 10.1016/j.jor.2024.06.035. eCollection 2024 Dec.

Abstract

BACKGROUND

Managing adult degenerative lumbar scoliosis (ADLS) presents a complex challenge, requiring advanced, minimally invasive surgical techniques.

OBJECTIVE

This study aims to evaluate and compare the efficacy and outcomes of oblique lateral interbody fusion (OLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in treating ADLS, with an emphasis on surgical methods, recovery times, and spinal correction results.

METHODS

We reviewed 42 patients with ADLS who did not respond to conservative treatments. These patients underwent either OLIF or MIS-TLIF procedures. Key factors analyzed included surgical duration, blood loss, complications, and changes in preoperative and postoperative lumbar lordosis (LL), anterior and posterior disc height (ADH, PDH), and Cobb angles. Statistical analysis was conducted using SPSS software, with significance determined at p < 0.05.

RESULTS

The OLIF technique showed notable benefits in multi-segment spinal corrections, particularly in enhancing intervertebral disc height and correcting Cobb angles. While both surgical methods effectively addressed spinal deformities, OLIF was less invasive, resulting in reduced blood loss, shorter surgery times, and fewer complications. No significant differences were found between the two techniques for single-segment corrections.

CONCLUSION

For multi-segment spinal corrections in ADLS, OLIF is a superior choice due to its minimal invasiveness and favorable recovery profile. However, for patients with primarily radicular symptoms and no significant postural alterations, MIS-TLIF may be more appropriate.

摘要

背景

成人退变性腰椎侧凸(ADLS)的治疗是一项复杂的挑战,需要先进的微创手术技术。

目的

本研究旨在评估和比较斜外侧椎间融合术(OLIF)和微创经椎间孔腰椎椎间融合术(MIS-TLIF)治疗ADLS的疗效和结果,重点关注手术方法、恢复时间和脊柱矫正效果。

方法

我们回顾了42例对保守治疗无反应的ADLS患者。这些患者接受了OLIF或MIS-TLIF手术。分析的关键因素包括手术持续时间、失血量、并发症以及术前和术后腰椎前凸(LL)、前后椎间盘高度(ADH、PDH)和Cobb角的变化。使用SPSS软件进行统计分析?p<0.05为有统计学意义。

结果

OLIF技术在多节段脊柱矫正中显示出显著优势,特别是在增加椎间盘高度和矫正Cobb角方面。虽然两种手术方法都能有效解决脊柱畸形问题,但OLIF的侵入性较小,导致失血量减少、手术时间缩短和并发症减少。在单节段矫正方面,两种技术之间未发现显著差异。

结论

对于ADLS的多节段脊柱矫正,OLIF因其微创性和良好的恢复情况是更好的选择。然而,对于主要有神经根症状且无明显姿势改变的患者,MIS-TLIF可能更合适。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ee3/11266858/e7c18ed50922/gr1.jpg

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