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Abstract：
Background: The usefulness and problems with lateral lumbar interbody fusion (LLIF) with a percutaneous pedicle screw (PPS) for dialysis-related spondyloarthropathy are not clear. Therefore, we investigated the usefulness and problems with LLIF with PPS in dialysis-related spondyloarthropathy. Methods: In total, 77 patients who underwent LLIF with PPS were divided into two groups: the dialysis-related spondyloarthropathy group (\"Group D\") consisted of 15 patients (10 males and 5 females) with a mean age of 70.4 years and a mean duration of hemodialysis of 10.8 years; and the lumbar degenerative disease group (\"Group L\") included 62 patients (31 males and 31 females) with a mean age of 71.0 years. The mean follow-up period was 4 years in Group D and 3 years 9 months in Group L. We compared surgical invasiveness (operative time, blood loss), perioperative complications, clinical outcomes (Improvement ratio of the JOA score), bone fusion rate, reoperation, sagittal alignment, and coronal imbalance between the two groups. Results: There were no significant differences in operative time, blood loss, or the improvement ratio of the JOA score, but dialysis-related spondyloarthropathy was observed in one patient with superficial infection, three patients with endplate failure, and one patient with restenosis due to cage subsidence. Conclusions: We consider LLIF with PPS for dialysis-related spondyloarthropathy to be an effective treatment option because its surgical invasiveness and clinical outcomes were comparable to those for cases of lumbar degenerative disease. However, as endplate failure due to bone fragility and a reduced bone fusion rate were observed in dialysis spondylolisthesis cases, we advise a careful selection of indications for indirect decompression as well as the application of suitable pre- and postoperative adjuvant therapies.
摘要：
背景：经皮椎弓根螺钉（PPS）外侧腰椎椎间融合术（LLIF）治疗透析相关脊柱关节病的有效性和问题尚不清楚。因此,我们调查了LLIF联合PPS在透析相关脊柱关节病中的作用和问题.方法：总计，77例接受LLIF和PPS治疗的患者分为两组：透析相关脊柱关节病组（“D组”）由15例患者（10例男性和5例女性）组成，平均年龄为70.4岁，平均持续时间为10.8年。腰椎退行性疾病组（“L组”）包括62例患者（男31例，女31例），平均年龄为71.0岁。D组的平均随访时间为4年，L组的平均随访时间为3年9个月。我们比较了手术侵袭性（手术时间，失血)，围手术期并发症,临床结果（JOA评分的改善率），骨融合率,再操作,矢状对齐,两组之间的日冕失衡。结果:两组手术时间无明显差异,失血,或者JOA分数的改善率，但在一名浅表感染患者中观察到与透析相关的脊柱关节病，三名终板衰竭患者，还有一名因笼子下沉而出现再狭窄的病人.结论：我们认为LLIF与PPS联合治疗透析相关脊柱关节病是一种有效的治疗选择，因为其手术侵袭性和临床结果与腰椎退行性疾病相当。然而,在透析腰椎滑脱病例中观察到由于骨脆性和骨融合率降低导致的终板失败，我们建议仔细选择间接减压的适应症，以及适当的术前和术后辅助治疗。
