Wang Zhiqiang, Guo Wei, Yang Wanzhong, Liu Xiaoyin, Liang Simin, Zhang Jianqun, Ge Zhaohui
Department of Orthopaedics, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou City, Henan, China.
Department of Orthopaedics, General Hospital of Ningxia Medical University, Yinchuan City, Ningxia, China.
Sci Rep. 2025 May 25;15(1):18252. doi: 10.1038/s41598-025-02414-z.
Unilateral pedicle screw (UPS) fixation has been applied in oblique lumbar interbody fusion (OLIF). However, the internal fixation strength required by OLIF is still controversial. Although satisfactory short-term outcome has been achieved with OLIF combined with UPS, the maintenance of stability in the fused segment remains a concern due to the lack of mid-term to long-term clinical follow-up reports. In this study, we compared the mid-term to long-term radiographic and clinical outcomes of unilateral (n = 100) versus bilateral (n = 86) instrumented one-level OLIF for lumbar degenerative disease (LDD).The mean follow-up duration was 75.09 ± 5.08 months. A significant decrease occurred in operative time, blood loss in UPS group. No statistical difference was detected regarding complication rate and fusion rate between the two groups. The VAS of low back pain at 6 months postoperatively was better than that of the BPS group. However, there were no significant differences in VAS and ODI at any other follow-up time point. The incidence of ASD was 12% lower in the UPS group than the 18.6% observed in the BPS group at the final follow-up. The standardized cross sectional area (SCSA) and degree of fat infiltration (DFF) of the multifidus muscle (MM) were better than those of the BPS group in the same period. The current data show that OLIF-UPS for the treatment of single-level LDD could achieve satisfactory mid-term to long-term outcomes comparable to BPS fixation, with less surgical time, less blood loss, and less DFF of the MM.
单侧椎弓根螺钉（UPS）固定已应用于斜外侧腰椎椎间融合术（OLIF）。然而，OLIF所需的内固定强度仍存在争议。尽管OLIF联合UPS已取得了令人满意的短期疗效，但由于缺乏中长期临床随访报告，融合节段的稳定性维持仍是一个问题。在本研究中，我们比较了单侧（n = 100）与双侧（n = 86）器械辅助单节段OLIF治疗腰椎退行性疾病（LDD）的中长期影像学和临床疗效。平均随访时间为75.09±5.08个月。UPS组的手术时间和失血量显著减少。两组在并发症发生率和融合率方面未检测到统计学差异。术后6个月时，UPS组的下腰痛视觉模拟评分（VAS）优于双侧椎弓根螺钉（BPS）组。然而，在任何其他随访时间点，VAS和腰椎功能障碍指数（ODI）均无显著差异。在最后随访时，UPS组相邻节段退变（ASD）的发生率比BPS组观察到的18.6%低12%。同期多裂肌（MM）的标准化横截面积（SCSA）和脂肪浸润程度（DFF）优于BPS组。目前的数据表明，OLIF-UPS治疗单节段LDD可取得与BPS固定相当的满意中长期疗效，手术时间更短，失血量更少，MM的DFF更小。
