Abstract:Objective To evaluate the early clinical value of stand-alone oblique lumbar interbody fusion (OLIF) and traditional posterior lumbar fusion in the treatment of degenerative lumbar diseases.Methods A total of 62 patients undergoing single-level stand-alone OLIF was divided into index surgery group (n=28) or revision surgery group (n=34) at single center,from August 2015 to February 2020 (minimum 12 months follow-up).The vertebral body Hounsfield unit (HU) value was measured to assess bone mineral density of operated level by preoperative CT.The following data were retrospectively collected and compared between the two groups:demographic,surgical data,clinical resultsand complications.The clinical parameters included operative time,intraoperative blood loss,X-ray exposure time,and hospital stay.Clinical outcome was assessed using the visual analogue scale (VAS) for back pain and the Oswestry disability index (ODI).Radiological outcomes included cage subsidence and intervertebral fusion through functional sagittal radiographic examination or CT scans of the lumbar spine if needed.Results 62 patients,with a mean follow-up of (34.6±9.1) months,were included in the case series.No differences were found between the two groups in surgical data and clinical outcomes including the operative time,intraoperative blood loss,X-ray exposure time,hospital stay,VAS for back pain and ODI scores,and fusion rate.The HU value of fused vertebral segments in the revision surgery group (149.1±35.7) was significantly higher than those of L1 vertebra (126.9±24.5) and L1~4 axes (126.0±26.5),and the differences were statistically significant (P=0.000).There were no significant differences between the HU value of fused vertebral segments in the initial surgery group (127.7±41.4) and those of L1 vertebra (133.0±40.3) and L1~4 axes (130.1±38.8) (P=0.064;P=0.227).Cage subsidence was observed in the revision group (n=1) and index group (n=7).There was no recurrence of lower extremity neurological symptoms,and no major complications such as revision surgery occurred.Conclusion Stand-alone OLIF is valid alternative to the traditional posterior apporach in the management of ASD with good clinical outcomes at short-term follow-up.The Research found,HU values of fusion segment were significantly higher than those including L1~4 horizontal plane and L1 in the patients with ASD,which may play a role in the management of ASD by stand-alone OLIF.
周蕾,周晶,刘超,袁超,王建 *. 单纯斜外侧腰椎间融合术治疗邻椎病早期临床疗效分析[J]. 实用骨科杂志, 2021, 27(11): 988-1009.
Zhou Lei,Zhou Jing,Liu Chao,et al. Early Outcome of Stand-alone Oblique Lumbar Interbody Fusion as Revision Surgery For the Treatment of Adjacent Segment Disease. sygkzz, 2021, 27(11): 988-1009.
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