Pfeiffer M, Griss P, Haake M, Kienapfel H, Billion M
Department of Orthopedic Surgery, Philipps University, Marburg, Germany.
Eur Spine J. 1996;5(5):299-307. doi: 10.1007/BF00304344.
A total of 113 patients, excluding those with tumor, spondylitis, and idiopathic scoliosis, underwent anterior lumbar interbody fusion (ALIF) with autologous iliac crest graft between 1984 and 1991 at our department. The proportion of these who were failed back patients was higher than that reported in the literature. Evaluation of functional outcome was feasible in 80 patients, utilizing Oswestry and Marburg scores, which were closely intercorrelated. The overall results yielded an improvement in the Oswestry score of 35.7 percentage points. A subset of 52 patients who were evaluated twice, showed the same results at an average of 6.6 years as they did at 2.3 years following surgery. Functional results showed a weak correlation with postoperative height loss of the intervertebral space. Influencing factors for the functional result were: postoperative compensation claim, age, and obesity. Of the professional people involved, 19.4% did not return to any occupation. Patients satisfied with the result had significantly greater functional improvement. Younger patients with additional dorsal distraction prior to ALIF for reduction of severe spondylolisthesis fared better than patients with ALIF alone. The rate of complications was low and did not contribute to the postoperative functional result. On the basis of these results further prospective studies have been designed and are currently underway.
1984年至1991年间，在我们科室，共有113例患者接受了前路腰椎椎间融合术（ALIF）并使用自体髂嵴移植，这些患者不包括患有肿瘤、脊柱炎和特发性脊柱侧凸的患者。这些失败的背痛患者的比例高于文献报道。利用Oswestry和Marburg评分对80例患者进行功能结果评估是可行的，这两个评分密切相关。总体结果显示Oswestry评分提高了35.7个百分点。52例接受两次评估的患者子集，在术后平均6.6年时的结果与术后2.3年时相同。功能结果与术后椎间隙高度丢失呈弱相关。功能结果的影响因素包括：术后赔偿要求、年龄和肥胖。在涉及的职业人群中，19.4%没有重返任何职业。对结果满意的患者功能改善明显更大。对于严重腰椎滑脱患者，在ALIF之前进行额外后路撑开复位的年轻患者比单纯接受ALIF的患者情况更好。并发症发生率较低，且对术后功能结果没有影响。基于这些结果，已经设计并正在进行进一步的前瞻性研究。
