OLIF联合皮质骨轨迹螺钉治疗腰椎退行性疾病的临床疗效分析

doi:10.13418/j.issn.1001-165x.2020.02.019

中国临床解剖学杂志 ›› 2020, Vol. 38 ›› Issue (2): 198-201.doi: 10.13418/j.issn.1001-165x.2020.02.019

OLIF联合皮质骨轨迹螺钉治疗腰椎退行性疾病的临床疗效分析

张世浩¹，　谭亮²，　林云志¹，　王洪¹，　方国芳¹，　桑宏勋¹

1.南方医科大学深圳医院骨科中心，广东深圳 518100； 2.株洲市中心医院脊柱骨科，湖南株洲 412000

收稿日期:2019-04-23 出版日期:2020-03-25 发布日期:2020-04-01
通讯作者: 桑宏勋，主任医师，E-mail：hxsang@fmmu.edu.cn
作者简介:张世浩（1981-），男，河南许昌人，主治医师，主要从事脊柱骨科方向研究，E-mail：zhshihao@sina.com
基金资助:
国家自然科学基金（81672180）；广东省医学科学技术研究基金（201811817285975）

The clinical effects analysis of OLIF and CBT screw for the treatment of lumbar degenerative diseases

ZHANG Shi-hao¹, TAN Liang², LIN Yun-zhi¹, WANG Hong¹, FANG Guo-fang¹, SANG Hong-xun¹

1. Department of Orthopaedics，Shenzhen Hospital of Southern Medical University, Shenzhen,518100 China;2. Department of Spine Surgery, Zhuzhou Center Hospital, Zhuzhou, 412000, China

Received:2019-04-23 Online:2020-03-25 Published:2020-04-01

摘要/Abstract

摘要： 目的　探讨斜前方入路腰椎椎间融合术（OLIF）联合后路皮质骨轨迹（CBT）螺钉内固定术治疗腰椎退行性疾病的临床疗效。方法　回顾性分析2016年4月至2018年4月接受OLIF手术治疗的32例患者的疗效。患者采用斜前方入路腰椎间盘切除减压术、OLIF术联合后路CBT螺钉内固定术进行治疗，记录患者的手术时间、术中出血量、并发症、椎间隙恢复高度、椎间融合时间等，下腰痛视觉模拟评分（VAS），患者Oswestry功能障碍指数（ODI）评价。结果　32例患者中，单节段患者25例，两节段5例，腰椎退行性变术后邻椎病2例。所有患者获得1~2年（平均1年）的随访。患者椎间隙恢复高度、腰椎前度角度、侧弯纠正角度与术前相比差异有统计学意义（P<0.05）；椎间融合时间为（3.2±1.3）月，腰腿痛VAS评分由术前平均（6.5±2.8）分下降至（2.5±1.7）分，差异有统计学意义（P<0.05）；ODI指数由术前（48.7±19.7）%下降至（15.2±9.6）%，手术前后比较有统计学差异（P<0.05）。结论　斜前方入路腰椎椎间盘切除减压术、OLIF术联合后路CBT螺钉内固定术治疗腰椎退行性疾病，创伤小、并发症少，对骨质疏松患者和邻椎病患者手术疗效显著，值得临床推广。

关键词: OLIF, 　CBT, 　邻椎病, 　骨质疏松

Abstract: Objective　To investigate the clinical effects of oblique lateral interbody fusion (OLIF) combined with cortical bone trajectory (CBT) screws internal fixation in the treatment of lumbar degenerative diseases.　Methods　32 cases with lumbar degenerative diseases were treated with OLIF and CBT screws fixation from April 2016 to April 2018. A retrospective analysis was performed to observe the operation time, intraoperative blood loss, complications, intervertebral height, intervertebral fusion time. The visual analogue scale (VAS), low back pain in patients with Oswestry disability index (ODI) were used to evaluate the clinical effect.　Results　All cases were followed up for 1-2 years, with an average of 1 year. There were 25 cases of single segment, 5 cases of two segments, 2 were adjacent segment disease after lumbar degeneration surgery, 13 male and 19 female in the 32 patients. There were statistical differences in the height of intervertebral recovery, lumbar anterior angle and lateral curvature correction angle between after operation and those of before operation (P<0.05).The intervertebral fusion time was 3.2±1.3 months, and the VAS score of lumbar and leg pain decreased from the preoperative average score (6.5±2.8) to (2.5±1.7) post-operation, (P<0.05).The ODI index decreased from (48.7±19.7) % pre-operation to (15.2±9.6) % post-operation (P<0.05).　Conclusions　OLIF combined with CBT internal fixation for the treatment of lumbar degenerative diseases is effective, with minimally invasive and few complications. It has significant clinical effect for the treatment for osteoporosis and adjacent segment disease surgery, and it is worthy in clinical application.

Key words: , OLIF, 　CBT, 　ASD, 　Osteoporosis

中图分类号:

R683.2

张世浩, 谭亮, 林云志, 王洪, 方国芳, 桑宏勋. OLIF联合皮质骨轨迹螺钉治疗腰椎退行性疾病的临床疗效分析[J]. 中国临床解剖学杂志, 2020, 38(2): 198-201.

ZHANG Shi-hao, TAN Liang, LIN Yun-zhi, WANG Hong, FANG Guo-fang, SANG Hong-xun. The clinical effects analysis of OLIF and CBT screw for the treatment of lumbar degenerative diseases[J]. Chinese Journal of Clinical Anatomy, 2020, 38(2): 198-201.

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OLIF联合皮质骨轨迹螺钉治疗腰椎退行性疾病的临床疗效分析

The clinical effects analysis of OLIF and CBT screw for the treatment of lumbar degenerative diseases

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