Hong Jae-Young, Soh Jaewan, Park Jiwon, Hwang Yoonjoong, Park Jihun, Suh Dong Hun
Department of Orthopaedic Surgery, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Republic of Korea.
Department of Orthopaedic Surgery, Hanyang University Guri Hospital, Guri, Republic of Korea.
Sci Rep. 2025 Jul 1;15(1):22188. doi: 10.1038/s41598-025-05562-4.
This retrospective study included 63 patients in whom 104 vertebral levels were surgically involved. Data on the efficacy of oblique lumbar interbody fusion (OLIF) for canal and foraminal stenosis of the lumbar spine were analyzed for a follow-up period as long as one year post-surgery. The factors associated with successful indirect decompression were evaluated by measuring disc height and spinal canal width changes. Radiological assessments of anterior disc height (ADH), posterior disc height (PDH), lumbar lordotic angle (LL), segmental lordotic angle (SL), foraminal height (FH), cross-sectional area (CSA) of the spinal canal, cross-sectional foraminal area (CSF), and subsidence (SD) were conducted in this study. The comparison of pre- and postoperative values demonstrated significant increases in both mean CSA and CSF (p < 0.001). FH increased from 15.23 ± 3.48 mm to 18.78 ± 2.93 mm and was stable as long as one year post-surgery (p < 0.0001). The VAS leg score and Oswestry Disability Index (ODI) significantly improved after surgery (p < 0.05). Immediate and one-year postoperative FH changes were significantly associated with changes in one-year postoperative ADH, PDH, and VAS leg score (p < 0.05). The positive (+) group, comprised of those who demonstrated FH improvement at one year postoperatively, also demonstrated significantly greater ADH and PDH changes immediately postoperatively compared with the FH negative (-) group (6.46 mm vs. 4.52 mm, p = 0.038 and 3.59 vs. 2.40, respectively; both p-values < 0.001). The CSF positive (+) group also showed significantly greater immediate postoperative ADH and PDH changes (6.24 mm vs. 4.55 mm, p = 0.043, and 3.00 vs. 1.57, p = 0.010, respectively). OLIF provided satisfactory indirect decompression for at least one year after surgery. Based on the FH increases, our findings indicated that optimal surgical outcomes are achieved with > 3.0 mm PDH changes and no over-distraction of the disc space.
这项回顾性研究纳入了63例患者,手术涉及104个椎体节段。分析了斜外侧腰椎椎间融合术(OLIF)治疗腰椎管和椎间孔狭窄的疗效数据,随访期长达术后一年。通过测量椎间盘高度和椎管宽度变化来评估与成功间接减压相关的因素。本研究对术前和术后的前椎间盘高度(ADH)、后椎间盘高度(PDH)、腰椎前凸角(LL)、节段性前凸角(SL)、椎间孔高度(FH)、椎管横截面积(CSA)、椎间孔横截面积(CSF)和沉降(SD)进行了影像学评估。术前和术后数值的比较显示,平均CSA和CSF均显著增加(p<0.001)。FH从15.23±3.48mm增加到18.78±2.93mm,术后长达一年保持稳定(p<0.0001)。术后视觉模拟评分法(VAS)腿痛评分和Oswestry功能障碍指数(ODI)显著改善(p<0.05)。术后即刻和术后一年的FH变化与术后一年的ADH、PDH和VAS腿痛评分变化显著相关(p<0.05)。阳性(+)组由术后一年FH改善的患者组成,与FH阴性(-)组相比,术后即刻ADH和PDH变化也显著更大(分别为6.46mm对4.52mm,p=0.038;3.59对2.40,p值均<0.001)。CSF阳性(+)组术后即刻ADH和PDH变化也显著更大(分别为6.24mm对4.55mm,p=0.043;3.00对1.57,p=0.010)。OLIF术后至少一年内提供了满意的间接减压。基于FH的增加,我们的研究结果表明,PDH变化>3.0mm且椎间盘间隙无过度撑开时可实现最佳手术效果。