生物骨科材料与临床研究2025，Vol.22Issue(2)：57-64,8.DOI:10.3969/j.issn.1672-5972.2025.02.010
三种不同微创腰椎融合术治疗L4/L5退变性滑脱的临床疗效比较
Clinical effect of three types of minimally invasive lumbar fusion surgery for treatment of L4/L5 degenerative spondylolisthesis
摘要
Abstract
Objective To evaluate the clinical effects of the transforaminal lumbar interbody fusion(MIS-TLIF),oblique lumbar interbody fusion(OLIF),and percutaneous endoscopic transforaminal lumbar interbody fusion(Endo-TLIF)on L4/L5 degenerative spondylolisthesis.Methods In this retrospective study,58 patients with L4/L5 degenerative spondylolisthesis received MIS-TLIF(MIS-TLIF group),55 patients received OLIF(OLIF group),and 68 patients received Endo-TLIF(Endo-TLIF group)between October 2019 and September 2022.We compared operative time,blood loss,drainage volume,hospital stay and complications,visual analog scale for back pain(VAS-B),visual analog scale for leg pain(VAS-L),and Oswestry Disability Index(ODI).We also performed imaging assessments,including lumbar lordosis angle(LLA),disc height(DH)and intervertebral fusion status.Results All patients were followed up for 18-36 months,with an average of(24.92±3.44)months.There were no significant differences in preoperative ODI,preoperative VAS-B,preoperative VAS-L,preoperative LLA,preoperative DH,or follow-up time.Patients who underwent OLIF had significantly less blood loss,a shorter hospital stay and a lower drainage volume,than those who underwent MIS-TLIF or Endo-TLIF(P<0.05).The VAS-B in the OLIF group significantly decreased significantly compared to the MIS-TLIF and Endo-TLIF groups at 3,6 and 12 months postoperatively(P<0.05).The VAS-L in the Endo-TLIF group significantly decreased compared to that in the MIS-TLIF and OLIF groups at 3 and 6 months postoperatively(P<0.05).The ODI in the OLIF group was significantly better than that in the MIS-TLIF and Endo-TLIF groups at 3 and 6 months postoperatively(P<0.05).There were no statistically significant differences in the incidence of complications was found among the three groups.The LLA and DH changes were significantly lower in the OLIF group than in the other groups at 6,12 months postoperatively and at final follow-up(P<0.05).The intervertebral fusion rate was significantly higher in the OLIF group than in the other groups at 6 and 12 months postoperatively and final follow-up(P<0.05).Conclusion In conclusion,although MIS-TLIF,OLIF,and Endo-TLIF techniques can effectively treat patients with L4/L5 degenerative spondylolisthesis,OLIF has more advantages,including less operative blood loss,a shorter hospital stay,a smaller drainage volume,efficacy for back pain,effective maintenance of lumbar lordosis angle and disc height,and a higher fusion rate.OLIF should be the preferred surgical treatment for patients with L4/L5 degenerative spondylolisthesis.关键词
腰椎滑脱/微创经椎间孔腰椎间融合术/斜外侧腰椎融合术/经皮内镜下经椎间孔腰椎融合术/融合率Key words
Lumbar degenerative spondylolisthesis/Minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)/Oblique lumbar interbody fusion(OLIF)/Percutaneous endoscopic transforaminal lumbar interbody fusion(Endo-TLIF)/Intervertebral fusion rate分类
临床医学引用本文复制引用
宋昭君,张智,郑佳状,汪凡栋,冉茂波,骆娟,张凯..三种不同微创腰椎融合术治疗L4/L5退变性滑脱的临床疗效比较[J].生物骨科材料与临床研究,2025,22(2):57-64,8.基金项目
四川省卫生健康科研课题普及应用项目(19PJYY0041) （19PJYY0041）
