独立前路斜交融合术矫正退行性腰椎畸形

Mohamed K. Elkazaz, A. Abou -Madawi, Hassan A. Alshatoury, Mohamed Alqazaz, Ahmed Abdemoniem, K. Salem
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引用次数: 1

摘要

背景数据:成人退行性脊柱侧弯的起点与成人脊柱侧弯有着相同的更广泛的定义,即在冠状面上测量的Cobb角大于10度。然而,它是专为以前有正常脊椎对齐的成年人。这种没有特定病因的病理学是由退行性腰椎疾病合并引起的。斜向腰椎融合术(OLIF)是一种常用的融合技术。它的引入是为了克服常用的椎间融合的缺点,如前部(ALIF)、外侧(LLIF)或后部(PLIF)椎间融合。OLIF可以实现脊柱稳定性,在冠状面和矢状面前方正确对齐平衡,并间接减压神经结构,与传统的经皮或腰后入路相关的并发症较少。研究设计:前瞻性临床病例研究。目的:评估独立(SA)OLIF后退行性腰椎畸形患者的冠状面和矢状面畸形矫正程度。患者和方法:符合特定纳入标准的ADS患者接受SA OLIF。对术前和术后临床数据(背痛VAS和ODI)、放射学数据(脊柱骨盆参数、节段Cobb角和椎间盘前高度)和术中数据(手术时间、失血量、“术中或术后”并发症和住院时间)进行了统计分析和比较。结果:共有28例患者和30个级别的患者接受了SA OLIF手术,平均年龄为50.54±6.05岁,其中男性14例,女性14例。平均手术时间/分钟、失血量/毫升和住院天数分别为91.29±14.23、195.54±42.299和2.78±0.875。背痛VAS平均值、腿部疼痛VAS平均值和ODI在1年内分别从术前的7.36±0.98、6.36±0.911和68.615±8.72变化为4.07±1.01、2.07±0.9和20.23±4.7。平均SVA、PT和Cobb角在1年内分别从12.93、19.21和10.39下降到8.93、18.42和7.04。
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Correcting Degenerative Lumbar Spine Deformity by Stand-Alone Anterior Oblique Lumbar Interbody Fusion
Background Data: Adult degenerative scoliosis has at its starting point the same broader definition of adult scoliosis, which is defined as a Cobb angle of greater than 10 degrees measured in the coronal plane. However, it is exclusive for adults who previously had normal spinal alignment. Such pathology with no specific etiology results from a combination of degenerative lumbar diseases. Oblique lumbar interbody fusion (OLIF) is one of the fusion techniques used. It was introduced to overcome the disadvantages of the commonly used interbody fusions like anterior (ALIF), lateral (LLIF), or posterior (PLIF) interbody fusions. OLIF can achieve spinal stability, correct alignment in coronal and sagittal balance anteriorly, and indirectly decompress neural structures with fewer complications related to traditional transpsoas or retropsoas approaches. Study Design: Prospective clinical case study. Objective: To assess the degree of coronal and sagittal deformity correction in patients suffering from degenerative lumbar spine deformities after stand-alone (SA) OLIF. Patients and Methods: Patients with ADS following specific inclusion criteria underwent SA OLIF. Preand postoperative clinical data (back and leg pain VAS and ODI), radiological data (spinopelvic parameters, segmental Cobb’s angle, and anterior disc height), and intraoperative data (operative time, amount of blood loss, “intraoperative or postoperative” complications, and hospital stay) were all analyzed and compared statistically. Results: A total of 28 patients and 30 levels underwent operation by SA OLIF, with a mean age of 50.54 ± 6.05 years, including 14 males and 14 females. The mean operative time/min, blood loss/ml, and hospital stay/day was 91.29 ± 14.23, 195.54 ± 42.299, and 2.78 ± 0.875, respectively. The mean of back pain VAS, the mean of leg pain VAS, and ODI changed from preoperatively 7.36 ± 0.98, 6.36 ± 0.911, and 68.615 ± 8.72 to 4.07 ± 1.01, 2.07 ± 0.9, and 20.23 ± 4.7 in 1 year, respectively. The average SVA, PT, and Cobb angle decreased from 12.93, 19.21, and 10.39 to 8.93, 18.42, and 7.04 in 1 year, respectively.
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