斜外侧椎间融合联合经皮置钉治疗腰椎滑脱症△

Oblique lateral interbody fusion combined with percutaneous pedicle screw fixation for lumbar spondylolisthesis

摘要:

［目的］ 探讨斜外侧腰椎椎间融合术 （oblique lateral interbody fusion, OLIF） 联合后路经皮椎弓根钉固定治疗腰椎滑脱症的临床效果。［方法］ 2018 年 10 月—2020 年 2 月，本院采用上述术式治疗 36 例 I、II 度腰椎滑脱症患者。总结临床和影像资料。［结果］所有患者均顺利完成手术，术中均无严重并发症，手术时间平均（112.24±13.51）min，出血量平均（103.62± 11.87）ml，手术切口均甲级愈合。末次随访时腰痛、下肢痛 VAS 评分及 ODI 较术前明显减少（P<0.05）。影像方面，与术前相比，末次随访时椎体滑脱率显著下降（P<0.05），而椎间隙高度及椎间孔高度显著增加（P<0.05），融合率为 100%。［结论］OLIF 联合经皮椎弓钉固定能有效复位滑脱，间接减压，早期临床疗效满意。

Abstract:

[Objective] To evaluate the clinical results of oblique lateral lumbar interbody fusion (OLIF) combined with percutaneous pedicle screw fixation for lumbar spondylolisthesis. [Methods] From October 2018 to February 2020, 36 patients underwent abovemen- tioned surgical operation for grade I and II lumbar spondylolisthesis in our hospital. The clinical and imaging consequences were summa- rized. [Results] All the patients were successfully operated on without serious complications, while with operative time of (112.24±13.51) min and intraoperative blood loss of (103.62±11.87) ml, and well incision healing. The VAS scores for low back pain and leg pain, as well as ODI score significantly decreased at the latest follow-up compared with those preoperatively (P＜0.05) . In terms of imaging, the extent of ver- tebral slippage decreased significantly (P＜0.05) , while the heights of intervertebral space and foramen increased significantly (P＜0.05) , with fusion rate of 100% at the latest follow up. [Conclusion] The OLIF combined with percutaneous pedicle screw fixation does effectively reduce spondylolisthesis, decompress indirectly, and achieve satisfactory clinical outcomes in the early stage.