单纯斜外侧椎间融合术在腰椎退行性疾病中的应用

目的探讨单纯斜外侧椎间融合术(OLIF)治疗腰椎退行性疾病的临床效果。方法采用OLIF治疗35例腰椎退行性疾病患者。采用疼痛VAS评分和ODI评分评估临床疗效;行腰椎X线、CT和MR检查,评价术后影像学改善程度;记录并发症情况。结果手术时间56~110(77±23)min。术中出血量30~180(63±35)ml。术后住院时间3~7(4.5±2.1)d。术后患者腰腿疼痛症状明显缓解。患者均获得随访,时间6~32个月。术后6个月VAS评分、ODI评分、椎间隙高度和椎间孔面积均较术前明显改善(P<0.001)。术后并发症发生率为20.0%(7/35):3例融合器沉降,二期联合后路肌间隙入路椎弓根螺钉固定;1例术侧腰大肌无力,1例术侧大腿前侧疼痛,1例对侧屈髋疼痛,1例术侧交感链损伤症状,4例随访过程中症状均缓解或消失。结论OLIF作为一种脊柱外科新技术,可获得良好的近期疗效,其远期疗效有待进一步观察。

Application of simple oblique lateral intervertebral fusion in lumbar degenerative diseases

Objective To investigate the efficacy of simple oblique lateral interbody fusion(OLIF)in the treatment of lumbar degenerative diseases.Methods The 35 patients with lumbar degenerative diseases were treated with OLIF.Pain visual analogue score(VAS)and Oswestry dysfunction index(ODI)were used to evaluate the clinical efficacy.Lumbar X-ray films,CT,and MRI were taken to evaluate the imaging improvement.Complications were recorded.Results The operative time was 56~110(77±23)min,intraoperative blood loss volume was 30~180(63±35)ml.Postoperative hospital stay was 3~7(4.5±2.1)d.All the patients had significant relieve of lumbar and lower limb pain.All patients were followed up from 6 months to 32 months.At 6 months after surgery,VAS,ODI score,intervertebral space height and vertebral foraminal area were all improved(P<0.001).The incidence rate of complications was 20.0%(7/35).There were settlement in 3 cases of postoperative fusion joint and underwent posterior pedicle screw fixation with lumbar intermuscular approach,1 case of bilateral psoas major weakness,1 case of lateral thigh pain of the side,1 case of lateral flexion hip pain,1 case of bilateral sympathetic chain damage symptoms,complications in the follow-up process had different degrees of relief or disappearance.Conclusions As a new technique of spine surgery,OLIF can obtain good short-term curative effect,but the long-term effect remains to be further observed.