Zheng Ke, Ni Zhihao, Han Guosong, Shan Tao, Xu Bin
Department of Orthopaedics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Department of Spine Surgery, The First People's Hospital of Hefei City, Hefei, Anhui, China.
Front Bioeng Biotechnol. 2024 Dec 17;12:1500234. doi: 10.3389/fbioe.2024.1500234. eCollection 2024.
In the current study, to demonstrate the advantages of oblique lateral interbody fusion (OLIF), we focused on the therapeutics for lumbar spinal tuberculosis with the comparison of three treatments, including anterior approach, posterior approach, and OLIF combined with posterior percutaneous pedicle screw fixation.
This study included patients with lumbar spinal tuberculosis from July 2015 to June 2018. We divided these patients into three groups: 35 patients underwent an anterior-only approach (Group A), 36 patients underwent a posterior-only approach (Group B), and 31 patients underwent OLIF combined with posterior percutaneous pedicle screw fixation (Group C). Operation time, blood loss, hospital stays, the visual analog scale (VAS) and the Oswestry disability index (ODI), ASIA grade, the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Cobb angle were used to evaluate the surgical approaches.
A total of 102 patients joined this study of three therapeutic groups. The mean hospital stays, the mean operative time, and surgical blood loss of the three groups of patients were (14.40 ± 2.6, 14.00 ± 2.51, and 9.39 ± 1.86) days, (177.23 ± 13.23, 198.00 ± 16.75, and 150.39 ± 14.28) minutes, and (307.43 ± 21.91, 406.67 ± 27.02, and 105.97 ± 18.90) mL, respectively. VAS and ODI of all patients significantly improved 1 week after surgery ( < 0.05). As all patients received regular anti-tuberculosis treatment before and after surgery, ESR and CRP indicators maintained at normal levels 1 week after surgery. The Cobb angle was significantly corrected 1 week after surgery ( < 0.05). Eight patients had postoperative complications, and all of them recovered after active treatment.
OLIF combined with posterior percutaneous pedicle screw fixation has the advantages of less surgical trauma and faster postoperative recovery, although all three surgical approaches can achieve satisfactory clinical results.
在本研究中，为了证明斜外侧椎间融合术（OLIF）的优势，我们重点关注腰椎结核的治疗方法，并比较了三种治疗方式，包括前路手术、后路手术以及OLIF联合后路经皮椎弓根螺钉内固定术。
本研究纳入了2015年7月至2018年6月期间的腰椎结核患者。我们将这些患者分为三组：35例患者接受单纯前路手术（A组），36例患者接受单纯后路手术（B组），31例患者接受OLIF联合后路经皮椎弓根螺钉内固定术（C组）。采用手术时间、失血量、住院时间、视觉模拟评分法（VAS）、Oswestry功能障碍指数（ODI）、美国脊髓损伤协会（ASIA）分级、红细胞沉降率（ESR）、C反应蛋白（CRP）以及Cobb角来评估手术方式。
共有102例患者参与了这三个治疗组的研究。三组患者的平均住院时间、平均手术时间和手术失血量分别为（14.40±2.6、14.00±2.51和9.39±1.86）天、（177.23±13.23、198.00±16.75和150.39±14.28）分钟以及（307.43±21.91、406.67±27.02和105.97±18.90）毫升。所有患者术后1周VAS和ODI均显著改善（P<0.05）。由于所有患者在手术前后均接受了正规的抗结核治疗，术后1周ESR和CRP指标维持在正常水平。术后1周Cobb角得到显著矫正（P<0.05）。8例患者出现术后并发症，经积极治疗后均康复。
尽管三种手术方式均能取得满意的临床效果，但OLIF联合后路经皮椎弓根螺钉内固定术具有手术创伤小、术后恢复快的优势。
