Abstract：
BACKGROUND: To observe the clinical efficacy of an anterior single rob-screw fixation (ASRSF) combined with the oblique lumbar intervertebral fusion (OLIF) approach compared with a posterior percutaneous screw fixation (PPSF) combined with OLIF in the treatment of lumbar spondylolisthesis.
METHODS: This is a retrospective case-control study. Patients with degenerative lumbar spondylolisthesis (DLS) treated with either ASRSF combined with OLIF or PPSF combined with OLIF from January 2016 to January 2018 were enrolled in this study. None of the patients had posterior decompression. The visual analog scale (VAS) and Oswestry dysfunction index (ODI) were used for clinical efficacy assessment. The pre- and post-operational disc height, height of foramen, subsidence, and migration of cages, fusion rate and surgery-related complications were compared between the two groups.
RESULTS: Fifty-three patients were included in this single-center study. According to the fixation methods, patients were divided into the ASRSF group (group A, 25 cases) and the PPSF group (group B, 28 cases). There was no statistical difference in surgery-related complications between groups. There was a significant difference in the VAS score at one-week post-surgery (2.3 ± 0.5 vs. 3.5 ± 0.4, P = 0.01), and three months post-operation (2.2 ± 0.3 vs. 3.0 ± 0.3, P = 0.01). Comparison of post-operative imaging data showed that there was a significant difference in the height of the foramen between groups at three months post-surgery(18.1 ± 2.3 mm vs. 16.9 ± 1.9 mm, P = 0.04). At 24 months post-surgery, the ODI was 12.65 ± 3.6 in group A and 19.1 ± 3.4 in group B (P = 0.01). Twelve months after surgery, the fusion rate in group A at 72.0% and 78.6% in group B was not statistically significant (P = 0.75). Fusion was identified in all patients at 24 months post-surgery.
CONCLUSIONS: When compared to PPSF, ASRSF combined with OLIF for DLS can reduce post-operative low back pain in the initial stages, maintain the height of the foramen and improve the performance of lumbar function.
METHODS: This is a retrospective case-control study. Patients with degenerative lumbar spondylolisthesis (DLS) treated with either ASRSF combined with OLIF or PPSF combined with OLIF from January 2016 to January 2018 were enrolled in this study. None of the patients had posterior decompression. The visual analog scale (VAS) and Oswestry dysfunction index (ODI) were used for clinical efficacy assessment. The pre- and post-operational disc height, height of foramen, subsidence, and migration of cages, fusion rate and surgery-related complications were compared between the two groups.
RESULTS: Fifty-three patients were included in this single-center study. According to the fixation methods, patients were divided into the ASRSF group (group A, 25 cases) and the PPSF group (group B, 28 cases). There was no statistical difference in surgery-related complications between groups. There was a significant difference in the VAS score at one-week post-surgery (2.3 ± 0.5 vs. 3.5 ± 0.4, P = 0.01), and three months post-operation (2.2 ± 0.3 vs. 3.0 ± 0.3, P = 0.01). Comparison of post-operative imaging data showed that there was a significant difference in the height of the foramen between groups at three months post-surgery(18.1 ± 2.3 mm vs. 16.9 ± 1.9 mm, P = 0.04). At 24 months post-surgery, the ODI was 12.65 ± 3.6 in group A and 19.1 ± 3.4 in group B (P = 0.01). Twelve months after surgery, the fusion rate in group A at 72.0% and 78.6% in group B was not statistically significant (P = 0.75). Fusion was identified in all patients at 24 months post-surgery.
CONCLUSIONS: When compared to PPSF, ASRSF combined with OLIF for DLS can reduce post-operative low back pain in the initial stages, maintain the height of the foramen and improve the performance of lumbar function.
摘要：
背景：观察前路单螺钉固定（ASRSF）联合斜腰椎椎间融合（OLIF）入路与后路经皮螺钉固定（PPSF）联合OLIF治疗腰椎滑脱的临床疗效。
方法：这是一项回顾性病例对照研究。本研究纳入2016年1月至2018年1月接受ASRSF联合OLIF或PPSF联合OLIF治疗的退行性腰椎滑脱（DLS）患者。没有患者进行后路减压。采用视觉模拟评分法(VAS)和Oswestry功能障碍指数(ODI)进行临床疗效评估。操作前和操作后的圆盘高度，孔的高度，沉降,和笼子的迁徙，比较两组患者的融合率及手术相关并发症。
结果：这项单中心研究纳入了53例患者。根据固定方法,患者分为ASRSF组(A组，25例）和PPSF组（B组，28例)。组间手术相关并发症无统计学差异。术后一周的VAS评分存在显着差异（2.3±0.5vs.3.5±0.4，P=0.01），术后三个月(2.2±0.3vs.3.0±0.3，P=0.01）。术后影像学数据的比较显示，术后三个月组间的孔高度存在显着差异（18.1±2.3mm与16.9±1.9mm,P=0.04)。手术后24个月,ODIA组为12.65±3.6,B组为19.1±3.4(P=0.01)。手术后12个月,A组融合率为72.0%,B组融合率为78.6%,差异无统计学意义(P=0.75)。所有患者均在术后24个月时确认融合。
结论：与PPSF相比，ASRSF联合OLIF用于DLS可以在初始阶段减轻术后下腰痛。保持孔的高度，改善腰椎功能的表现。
方法：这是一项回顾性病例对照研究。本研究纳入2016年1月至2018年1月接受ASRSF联合OLIF或PPSF联合OLIF治疗的退行性腰椎滑脱（DLS）患者。没有患者进行后路减压。采用视觉模拟评分法(VAS)和Oswestry功能障碍指数(ODI)进行临床疗效评估。操作前和操作后的圆盘高度，孔的高度，沉降,和笼子的迁徙，比较两组患者的融合率及手术相关并发症。
结果：这项单中心研究纳入了53例患者。根据固定方法,患者分为ASRSF组(A组，25例）和PPSF组（B组，28例)。组间手术相关并发症无统计学差异。术后一周的VAS评分存在显着差异（2.3±0.5vs.3.5±0.4，P=0.01），术后三个月(2.2±0.3vs.3.0±0.3，P=0.01）。术后影像学数据的比较显示，术后三个月组间的孔高度存在显着差异（18.1±2.3mm与16.9±1.9mm,P=0.04)。手术后24个月,ODIA组为12.65±3.6,B组为19.1±3.4(P=0.01)。手术后12个月,A组融合率为72.0%,B组融合率为78.6%,差异无统计学意义(P=0.75)。所有患者均在术后24个月时确认融合。
结论：与PPSF相比，ASRSF联合OLIF用于DLS可以在初始阶段减轻术后下腰痛。保持孔的高度，改善腰椎功能的表现。
