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斜外侧腰椎椎间融合术治疗单节段退变性腰椎疾病的临床价值

Clinical values of oblique lumbar interbody fusion on the treatment of single-level degenerative lumbar diseases.

作者信息

Yu Yu

机构信息

Department of Orthopedics, The Second People's Hospital of Hefei, Hefei, China.

出版信息

Front Surg. 2024 Sep 5;11:1424262. doi: 10.3389/fsurg.2024.1424262. eCollection 2024.

Abstract

OBJECTIVES

Minimally invasive transforaminal lumbar interbody fusion (Mis-TLIF) and oblique lumbar interbody fusion (OLIF) are increasingly replacing traditional approaches. This study aimed to compare the clinical outcomes of OLIF and Mis-TLIF in treating single-level degenerative lumbar diseases.

METHODS

Patients with single-level degenerative lumbar diseases underwent either OLIF (30 patients) or Mis-TLIF (30 patients). Surgical data, including operation time, blood loss, postoperative drainage, and postoperative bed rest duration, were collected. Clinical outcomes were assessed using the Oswestry disability index, the visual analog scale scores for low back pain and leg pain, and Japanese Orthopaedic Association scores for daily ability, along with monitoring of complications.

RESULTS

The OLIF group showed significantly shorter operative times, less blood loss, reduced postoperative drainage, and shorter bed rest durations than the Mis-TLIF group. At the 1-month follow-up, OLIF patients also demonstrated significantly better clinical outcome scores than Mis-TLIF patients. No significant differences were observed between OLIF and Mis-TLIF patients before surgery and after 3 months. Furthermore, lumbar lordosis and disc height were significantly greater in the OLIF group at the final follow-up.

CONCLUSIONS

Both OLIF and Mis-TLIF achieved satisfactory and effective long-term clinical outcomes for single-level lumbar degenerative diseases. However, OLIF resulted in less tissue damage, reduced bleeding, better short-term clinical outcomes, and improved recovery of segmental lordosis compared to Mis-TLIF. Therefore, OLIF appears to be the preferable option over Mis-TLIF.

摘要

目的

微创经椎间孔腰椎椎间融合术(Mis-TLIF)和斜外侧腰椎椎间融合术(OLIF)正越来越多地取代传统手术方法。本研究旨在比较OLIF和Mis-TLIF治疗单节段退变性腰椎疾病的临床疗效。

方法

单节段退变性腰椎疾病患者分别接受OLIF手术(30例)或Mis-TLIF手术(30例)。收集手术数据,包括手术时间、失血量、术后引流量和术后卧床时间。使用Oswestry功能障碍指数、下腰痛和腿痛的视觉模拟量表评分以及日本骨科协会日常活动能力评分评估临床疗效,并监测并发症。

结果

与Mis-TLIF组相比,OLIF组手术时间明显更短,失血量更少,术后引流量减少,卧床时间更短。在1个月的随访中,OLIF患者的临床疗效评分也明显优于Mis-TLIF患者。术前和术后3个月,OLIF组和Mis-TLIF组患者之间未观察到显著差异。此外,在末次随访时,OLIF组的腰椎前凸和椎间盘高度明显更大。

结论

OLIF和Mis-TLIF对单节段腰椎退变性疾病均取得了满意且有效的长期临床疗效。然而,与Mis-TLIF相比,OLIF导致的组织损伤更小,出血更少,短期临床疗效更好,节段性前凸恢复更佳。因此,与Mis-TLIF相比,OLIF似乎是更优的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65d1/11410773/da3bc23858f1/fsurg-11-1424262-g001.jpg

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