退行性脊柱侧弯单节段椎管狭窄斜外侧椎间融合

Oblique lateral intervertebral fusion for degenerative scoliosis accompanied with a single- segment spinal canal stenosis

摘要:

[目的] 报告斜外侧椎间融合术 (oblique lateral interbody fusion, OLIF) 治疗退变性脊柱侧弯单节段椎管狭窄的临床效果。[方法]2016 年 8 月—2018 年 12 月，对 18 例退变性脊柱侧弯合并单节段椎间狭窄患者行 OLIF 术，总结患者的临床与影像资料。[结果]所有患者均顺利完成手术，均未出现严重的神经及血管损伤。所有患者随访 12~24 个月，平均(16.32±3.72) 个月。与术前相比，末次随访时，患者的 VAS 和 ODI 评分均显著下降(P＜0.05)。影像方面，与术前相比，末次随访时患者责任节段椎间隙高度和椎管面积显著增加(P＜0.05)；而侧弯 Cobb 角减小，但差异无统计学意义(P＞0.05)。于术后 16 周内，所有患者均达到椎间融合。[结论]OLIFF 可以有效解除退行性脊柱侧单节段椎管或神经根管狭窄所致的神经根压迫或激惹，手术创伤小，临床效果满意。

Abstract:

[Objective] To report the clinical results of oblique lateral interbody fusion (OLIF) for treatment of degenerative scoliosis ac- companied with a single-segment spinal stenosis. [Methods] From August 2016 to December 2018, OLIF was performed on 18 patients with degenerative scoliosis accompanied with single-segment spinal canal stenosis. The clinical and imaging documents of the 18 patients were summarized. [Results] All the patients had the operations completed successfully, without serious complications, such as nerve and blood vessel damages. All patients were followed up for 12~24 months, with an average of (16.32±3.72) months. Compared with those preop- eratively, the VAS and ODI scores decreased significantly at the latest follow-up (P＜0.05) . In terms of imaging assessment, the height of the responsible intervertebral space and foraminal area increased significantly at the last follow-up (P＜0.05) ; while the Cobb angle of sco- liosis decreased, but without a statistically significant difference, compared with those preoperatively (P＞0.05) . Within 16 weeks after sur- gery, all patients achieved intervertebral fusion. [Conclusion] OLIF does effectively relieve the nerve root compression or irritation caused by a single-segment spinal canal or nerve root canal stenosis in degenerative scoliosis, with minimalized surgical trauma and satisfactory clinical results.