经前侧方腹膜后入路腰椎椎间融合术治疗腰椎退行性疾病的临床疗效

摘要

目的 探讨经前侧方腹膜后入路腰椎椎间融合术(OLIF)治疗腰椎退行性疾病的临床疗效.方法 2015年11月—2016年9月,本院采用OLIF治疗腰椎退行性疾病患者16例.记录患者手术前后日本骨科学会(JOA)评分、疼痛视觉模拟量表(VAS)评分、椎间隙和椎间孔高度及并发症发生情况,以评价手术疗效.结果 16例患者均在OLIF微创管道下顺利完成所有手术,随访时间7~17个月.所有患者术后复查均未见椎弓根钉松动、断裂或Cage移位.至末次随访,仅1例椎间隙尚未融合,其余所有节段均已融合;2例Cage下沉,未见置入物松动;切口均一期愈合.所有患者术后腰椎JOA、VAS评分均优于术前,差异具有统计学意义(P<0.05);术后椎间隙前缘、后缘及椎间孔高度均优于术前,差异具有统计学意义(P<0.05).结论 OLIF手术效果佳、并发症少,是治疗腰椎退行性疾病的一种较好的方法.%Objective To explore clinical efficacy of oblique lumbar interbody fusion(OLIF) in treatment of lumbar degenerative diseases. Methods From November 2015 to September 2016,16 patients with lumbar degenerative disease were treated with OLIF. The Japanese Orthopaedic Association(JOA) score,visual analogue scale(VAS) score,intervertebral space and intervertebral foramen height and complications were recorded to evaluate the therapeutic effect of the operation. Results All the patients were operated successfully,and followed up for 7 - 17 months. No loosening,breakage of pedicle screws or Cage displacement were found in all the patients at the follow-up. By the end of the follow-up,all the segments had been fused but 1 segment;Cage subsidence occured in 2 cases,and no implant loosening was seen,and the incision healed primarily. The postoperative VAS and JOA score were superior to those of pre-operation with statistical significance(P<0.05);the heights of anterior and posterior margins of the intervertebral space and intervertebral foramen were better than those before the operation with statistical significance(P < 0.05). Conclusion The OLIF is an effective operation method with less complications in treating lumbar degenerative disease.