临床外科杂志 ›› 2022, Vol. 30 ›› Issue (4): 323-327.doi: 10.3969/j.issn.1005-6483.2022.04.007

• 论著 • 上一篇    下一篇

经皮内镜与斜外侧腰椎椎间融合术治疗外伤性Ⅰ、Ⅱ度腰椎滑脱的疗效观察 

  

  1. 264400 山东省文登整骨医院脊柱脊髓三科(王欢、王振宇、侯海涛、黄相鹏、付松、王亚楠、刘海军、王龙强、邵诗泽);上海市浦东新区中医医院针灸康复科(黄奏琴)
  • 收稿日期:2021-09-08 接受日期:2021-09-08 出版日期:2022-04-20 发布日期:2022-04-20

Clinical efficacy of percutaneous endoscopy and oblique lumbar interbody fusion in the treatment of traumatic Ⅰ and Ⅱ grade spondylolisthesis

  1. Department of Spine and Spinal Cord,Wendeng Orthopedic Hospital,Shandong,Weihai 264400, China
  • Received:2021-09-08 Accepted:2021-09-08 Online:2022-04-20 Published:2022-04-20

摘要: 目的 比较经皮内镜与斜外侧腰椎椎间融合术(oblique lumbar interbody fusion,OLIF) 治疗外伤性Ⅰ、Ⅱ度腰椎滑脱(Meyerding)的疗效。 方法 2018年3月~2020年1月我院收治的外伤性Ⅰ、Ⅱ度腰椎滑脱病人155例。根据手术方法不同分为两组,A组76例,行经皮内镜辅助腰椎椎间融合治疗,B组79例,行斜外侧腰椎椎间融合术。观察两组手术情况,术前、术后3个月及术后12个月椎间盘高度、椎间孔及宽度、腰椎前凸角、视觉模拟疼痛量表(VAS)、Oswestry残疾指数(ODI)、36项简明健康调查量表(SF-36)和并发症。 结果 A组手术时间、手术失血量分别为(155.32±10.21)分钟和(35.10±8.65)ml,B组手术时间、手术失血量分别为(160.43±19.87)分钟和(80.10±13.91)ml,两组比较差异有统计学意义(P<0.05)。与B组比较,A组术后3个月及术后12个月椎间孔较小、椎间孔宽度较大,两组比较差异有统计学意义(P<0.05),两组腰椎前凸角比较差异无统计意义(P>0.05)。与B组比较,A组术后3个月SF-36评分升高,两组比较差异有统计学意义(P<0.05);术后3个月两组VAS、ODI及术后12个月SF-36评分比较差异无统计意义(P>0.05)。两组术后3个月及术后12个月并发症比较差异无统计意义(P>0.05)。 结论 与斜外侧腰椎椎间融合术比较,经皮内镜辅助腰椎间融合术治疗外伤性Ⅰ、Ⅱ度腰椎滑脱安全可行,近期疗效确切。

关键词: 经皮内镜, 腰椎椎间融合术, 斜外侧腰椎椎间融合术, 腰椎滑脱, 疼痛, 生活质量

Abstract: Objective To explore the clinical efficacy of percutaneous endoscopy and oblique lateral lumbar interbody fusion(olif) in the treatment of traumatic grade Ⅰ and Ⅱ lumbar spondylolisthesis(meyerding). Methods 155 patients with traumatic grade Ⅰ and Ⅱ lumbar spondylolisthesis treated in our hospital from March 2018 to January 2020 were selected.According to different surgical methods,they were divided into two groups.Group A(76 cases) underwent percutaneous endoscopic assisted lumbar interbody fusion,and group B(79 cases) underwent oblique lateral lumbar interbody fusion.The operation conditions of the two groups,preoperative,3 months and 12 months after operationintervertebral disc height,intervertebral foramen and width,lumbar lordosis,visual analog pain scale(VAS),Oswestry disability index(ODI),36 concise health survey scale(SF-36) and complications were observed. Results The operation time and blood loss in group A were (155.32±10.21)min and (35.10±8.65)ml,respectively;The operation time and blood loss in group B were (160.43±19.87)min and (80.10± 13.91 )ml,respectively(P<0.05).Compared with group B,group A had smaller intervertebral foramen and larger intervertebral foramen width 3 months and 12 months after operation(P<0.05).There was no statistical significance in the comparison of lumbar lordosis angle between the two groups(P>0.05).Compared with group B,the scores of 36 items of concise health survey scale in group a increased(P<0.05).There was no statistical significance between the two groups in VAS,ODI at three months after surgery and SF-36 scores at 12 months after operation(P>0.05).There was no statistically significant difference in complications between the two groups at 3 months and 12 months after surgery(P>0.05).Conclusion Compared with oblique lateral lumbar interbody fusion,percutaneous endoscopic assisted lumbar interbody fusion is safer and more effective in the treatment of traumatic grade Ⅰ and Ⅱ lumbar spondylolisthesis.

Key words: percutaneous endoscopy, lumbar interbody fusion, oblique lumbar interbody fusion, low-grade lumbar spondylolisthesis, pain, quality of life

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