| 斜外侧椎间融合术联合侧路固定与经椎间孔椎间融合术在腰椎管狭窄症中的早中期疗效比较 |
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Received:November 17, 2024
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| 作者 | Author | 单位 | Unit | E-Mail |
| 李人杰 |
LI Ren-jie |
苏州大学附属第四医院苏州市独墅湖医院骨科, 江苏 苏州 215123 |
Department of Orthopedics, Dushuhu Hospital, Suzhou, the Fourth Affiliated Hospital of Suzhou University, Suzhou 215123, Jiangsu, China |
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| 姜为民 |
JIANG Wei-min |
苏州大学附属第四医院苏州市独墅湖医院骨科, 江苏 苏州 215123 |
Department of Orthopedics, Dushuhu Hospital, Suzhou, the Fourth Affiliated Hospital of Suzhou University, Suzhou 215123, Jiangsu, China |
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| 陈唐亦衡 |
CHEN Tang-yi-heng |
苏州大学附属第四医院苏州市独墅湖医院骨科, 江苏 苏州 215123 |
Department of Orthopedics, Dushuhu Hospital, Suzhou, the Fourth Affiliated Hospital of Suzhou University, Suzhou 215123, Jiangsu, China |
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| 杨森 |
YANG Sen |
苏州大学附属第四医院苏州市独墅湖医院骨科, 江苏 苏州 215123 |
Department of Orthopedics, Dushuhu Hospital, Suzhou, the Fourth Affiliated Hospital of Suzhou University, Suzhou 215123, Jiangsu, China |
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| 刘义杰 |
LIU Yi-jie |
苏州大学附属第四医院苏州市独墅湖医院骨科, 江苏 苏州 215123 |
Department of Orthopedics, Dushuhu Hospital, Suzhou, the Fourth Affiliated Hospital of Suzhou University, Suzhou 215123, Jiangsu, China |
liuyijie@suda.edu.cn |
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| 期刊信息：《中国骨伤》2025年25卷，第5期，第465-472页 |
| DOI：10.12200/j.issn.1003-0034.20230398 |
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目的:比较斜外侧椎间融合术(oblique lateral interbody fusion,OLIF)联合侧路固定与经椎间孔椎间融合术(transforaminal lumbar interbody fusion,TLIF)治疗腰椎管狭窄症的临床疗效。
方法:回顾分析2018年12月至2021年11月因腰椎管狭窄症手术患者47例,根据手术入路不同分为两组:间接减压组(OLIF组)21例,男5例,女16例,年龄55~74(68.19±6.13)岁,采用斜外侧入路联合侧路椎弓根钉固定;直接减压组(TLIF组)26例,男8例,女18例,年龄54~78(65.35±7.64)岁,采用后入路减压。采用疼痛视觉模拟评分(visual analogue scale,VAS)、椎间隙高度、椎间孔高度、冠状面和矢状面Cobb角、椎管矢状径、椎管面积等指标比较两组临床疗效。
结果:所有患者术后疗效良好,伤口正常愈合,术后随访获得骨性融合。两组患者术后均未发生严重并发症,间接减压组左侧大腿一过性无力4例,直接减压组出现1例硬膜撕裂、脑脊液漏。间接减压组随访时间(20.43±4.80)个月,直接减压组随访时间(21.69±4.37)个月。两组患者在骨密度、身体质量指数、住院时间、冠状位及矢状位Cobb角方面比较,差异均无统计学意义(P>0.05)。两组患者在出血量、手术时间、椎间隙高度、椎间孔高度方面比较,差异均有统计学意义(P<0.05)。两组患者术后椎管面积、椎管矢状径较术前改善明显。
结论:两组患者术后均获得良好的临床疗效,与TLIF相比,OLIF侧路椎弓根钉固定在减少出血、创伤等方面具备明显优势。与后路减压融合相比,OLIF联合侧路固定具备创伤小、恢复快的优势。 |
| [关键词]:腰椎 内固定 椎间融合 斜外侧椎间融合术 经椎间孔椎间融合术 微创 |
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| Comparison of the early and medium term efficacy of oblique lateral interbody fusion combined lateral fixation and transforaminal lumbar interbody fusion in lumbar spinal stenosis |
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Abstract:
Objective To compare the clinical efficacy of oblique lateral interbody fusion(OLIF) combined with lateral fixation and transforaminal lumbar interbody fusion(TLIF) in patients with lumbar spinal stenosis.
Methods Totally 47 patients with lumbar stenosis from November 2018 to December 2021 were analyzed retrospectively and were divided into two groups according to the surgical methods. Among them,21 cases underwent oblique lumbar interbody fusion supplemental anterolateral screw and rod instrumentation,including 5 males and 16 females,with a mean age of (68.19±6.13) years old ranging 55 to 74 years; the other 26 cases underwent posterior pedicle screw fixation and reduction were recorded,including 8 males and 18 females with a mean age of (65.35±7.64) years old ranging 54 to 78 years. Visual analogue scale(VAS) of pain was recorded to evaluate the degree of low back pain and lower extremity pain. The radiographic parameters were collected to evaluate the efficacy of two approaches including disc height,foraminal height,canal sagittal diameter and cross-sectional area.
Results All operations were completed successfully. The wound healed normally and bone fusion was obtained in the last final follow up. No serious complication was occurred in both groups. One case of dural tear occurred in direct compression group. Four cases of left thigh weakness and pain were recorded in indirect decompression group. The average postoperative follow-up was(21.69±4.37)months in direct compression group,while(20.43±4.80)months in another group. There were no significant difference in bone density,body mass index(BMI),hospital stay,Cobb angel(P>0.05). The differences in intra-operative blood loss,operation time,disc height,foraminal height between two groups were statistically significant(P<0.05). The area and sagittal diameter of the spinal canal in the two groups were significantly improved after surgery(P<0.05).
Conclusion Both two fusion Methods have achieved good clinical Results in the treatment of lumbar spinal stenosis,with the advantages of good stability,fast recovery and high fusion rate. Compared with TLIF,the advantage of OLIF has greater advantages in less bleeding and less trauma. |
| KEYWORDS:Lumbar vertebra Internal fixation Intervertebral fusion Oblique lateral interbody fusion Transforaminal lumbar interbody fusion Minimal invasive |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李人杰,姜为民,陈唐亦衡,杨森,刘义杰.斜外侧椎间融合术联合侧路固定与经椎间孔椎间融合术在腰椎管狭窄症中的早中期疗效比较[J].中国骨伤,2025,25(5):465~472 |
| 英文格式: | LI Ren-jie,JIANG Wei-min,CHEN Tang-yi-heng,YANG Sen,LIU Yi-jie.Comparison of the early and medium term efficacy of oblique lateral interbody fusion combined lateral fixation and transforaminal lumbar interbody fusion in lumbar spinal stenosis[J].zhongguo gu shang / China J Orthop Trauma ,2025,25(5):465~472 |
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