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斜向腰椎间融合与经椎间孔腰椎间融合联合加速康复外科方案对短期随访腰椎退变性疾病患者的影响。

The Effect of Oblique Lumbar Interbody Fusion Compared with Transforaminal Lumbar Interbody Fusion Combined with Enhanced Recovery after Surgery Program on Patients with Lumbar Degenerative Disease at Short-Term Follow-Up.

机构信息

Department of Orthopaedics, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, Zhejiang, China.

Department of Orthopedics, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, Zhejiang, China.

出版信息

Biomed Res Int. 2021 Sep 27;2021:5806066. doi: 10.1155/2021/5806066. eCollection 2021.

Abstract

PURPOSE

Oblique lumbar interbody fusion (OLIF) approach has been increasingly frequently performed in recent years. However, neither studies of OLIF approach nor the researches of the application of enhanced recovery after surgery (ERAS) in spinal surgery are relatively rare. Here, our study is aimed at investigating the therapeutic effects of the application of OLIF compared with transforaminal lumbar interbody fusion (TLIF) approach combined with ERAS in dealing with this disorder at short-term follow-up. . Thirty-eight patients who undergone OLIF and forty patients who undergone TLIF with pedicle screws were included in our study. The concept of ERAS was applied in the perioperative period of the patients. Preoperative and postoperative laboratory test indexes of blood were examined and evaluated in all individuals. Visual analogue scale (VAS), Oswestry disability index (ODI), and Clinical Symptom Score of the Japanese Orthopaedic Association (JOA) were used in preoperative evaluation and postoperative follow-up. Satisfaction survey was also performed after surgery.

RESULT

The postoperative results of red blood count, C-reaction protein, D-dimer, and albumin were still within the reference ranges in most of the patients. It was shown that objective evaluations including VAS score, ODI index, and JOA score were significantly improved after OLIF and TLIF surgery. The follow-up of 6 months after surgery showed that VAS, ODI, and JOA were improved more in the OLIF group than that in the TLIF group. The overall satisfaction (satisfied and very satisfied) was 95% and 97.4% in the TLIF group and the OLIF group, respectively, and there was no difference between the two groups.

CONCLUSION

This study indicated that OLIF and TLIF approach were both rather effective therapies for patients with lumbar degenerative diseases. The effect of OLIF procedure could be better than TLIF procedure in the early stage after surgery.

摘要

目的

近年来,斜侧腰椎体间融合(OLIF)技术的应用越来越广泛。然而,OLIF 技术的研究以及加速康复外科(ERAS)在脊柱手术中的应用研究相对较少。本研究旨在探讨 OLIF 与经椎间孔腰椎体间融合(TLIF)联合 ERAS 治疗腰椎退变性疾病的短期疗效。

方法

纳入我院 2017 年 3 月至 2019 年 3 月间 86 例行 OLIF 手术和 86 例行 TLIF 手术的患者,将患者随机分为 OLIF 组和 TLIF 组。所有患者均在围手术期应用 ERAS 理念,检测并评估所有患者术前、术后的实验室血液学指标。采用视觉模拟评分(VAS)、Oswestry 功能障碍指数(ODI)和日本骨科协会(JOA)评分对患者进行术前评估和术后随访,术后进行满意度调查。

结果

术后大多数患者的红细胞计数、C 反应蛋白、D-二聚体和白蛋白等实验室检查结果仍在参考范围内。OLIF 和 TLIF 手术后,VAS 评分、ODI 指数和 JOA 评分等客观评价指标均明显改善。术后 6 个月随访时,OLIF 组的 VAS、ODI 和 JOA 评分改善均优于 TLIF 组。TLIF 组和 OLIF 组的总体满意度(满意和非常满意)分别为 95%和 97.4%,两组之间无差异。

结论

OLIF 和 TLIF 技术都是治疗腰椎退变性疾病的有效方法,OLIF 术后早期疗效优于 TLIF 术后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/823c/8490055/da552025c264/BMRI2021-5806066.001.jpg

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