Department of Spinal Surgery, The Third Hospital of Shijiazhuang, Shijiazhuang, People's Republic of China.
J Orthop Surg Res. 2024 Aug 27;19(1):514. doi: 10.1186/s13018-024-05022-1.
Oblique lumbar interbody fusion (OLIF) still has a steep learning curve that many spinal surgeons who want to develop are hesitant. The purpose of this study is to provide reference for beginners through the comparative analysis of the application of two kinds of retraction devices in the early stage of learning curve.
We prospectively included the first 60 patients with lumbar degenerative diseases treated with OLIF by a surgeon in our department. According to the application of different retraction devices during the operation, the patients were divided into hook retractor group and tubular retractor group. The clinical effects and complications of the two groups were compared.
The average age of hook retractor group was 62 years old, the average age of tubular retractor group was 65 years old. There was no significant difference in age, sex, operative segment, follow-up time and blood loss between the two groups. The operation time in hook retractor group was less than that in tubular retractor group. The incidence of complications in hook retractor group (11.8%) was significantly lower than that in tubular retractor group (38.5%).
The tubular retractor group has a higher risk of neurovascular injury in the initial stage of learning, as well as the risk of vertebral fracture. In contrast, the hook retractor group has the advantages of simple method, high fault tolerance and relatively low incidence of complications. Therefore, we believe that the application of hook retractor in the early stage of OLIF learning curve is easier to increase the operator's confidence and make OLIF more acceptable.
斜侧腰椎体间融合术（OLIF）仍然存在陡峭的学习曲线，许多想要发展该技术的脊柱外科医生都犹豫不决。本研究的目的是通过对两种牵开器在学习曲线早期应用的对比分析，为初学者提供参考。
我们前瞻性地纳入了由我科医生治疗的 60 例腰椎退行性疾病患者。根据手术中使用的不同牵开器，将患者分为钩式牵开器组和管状牵开器组。比较两组的临床效果和并发症。
钩式牵开器组的平均年龄为 62 岁，管状牵开器组的平均年龄为 65 岁。两组在年龄、性别、手术节段、随访时间和出血量方面均无统计学差异。钩式牵开器组的手术时间短于管状牵开器组。钩式牵开器组的并发症发生率（11.8%）明显低于管状牵开器组（38.5%）。
在学习曲线的初始阶段，管状牵开器组发生神经血管损伤和椎体骨折的风险较高。相比之下，钩式牵开器组具有方法简单、容错性高、并发症发生率相对较低的优点。因此，我们认为在 OLIF 学习曲线的早期应用钩式牵开器更容易增加术者的信心，使 OLIF 更易于接受。
