Abstract：
OBJECTIVE: To evaluate the outcomes of Oblique lumbar interbody fusion (OLIF)combined with anterolateral screw fixation (AF) and Stress Endplate Augmentation(SEA) versus OLIF-AF in the treatment of degenerative lumbar spondylolisthesis (DLS)with osteoporosis (OP).
METHODS: 30 patients underwent OLIF-AF-SEA (SEA group) were matched with 30 patients received OLIF-AF (control group), in terms of sex, age, body mass index (BMI) and bone mineral density (BMD). Clinical outcomes including visual analog scale (VAS) score of the lower back pain (VAS-LBP), leg pain (VAS-LP), and Oswestry Disability Index (ODI) were evaluated at different postoperative intervals and comparedwith their preoperative counterparts. Radiographic outcomes such as disk height (DH), slip distance (SD), lumbar lordosis (LL), segmental lordosis (SL), cage subsidence (CS) rate and fusion rate were evaluated at different postoperative intervals and compared with their preoperative counterparts.
RESULTS: SEA group presented to be better at 3-month and 12-month follow-up, the VAS-LBP, VAS-LP and ODI scores of the SEA group were significantly lower than the control group (3-month SEA vs control: 2.30±0.70 vs 3.30±0.75, 2.03±0.72 vs 2.90±0.76,15.60±2.36 vs 23.23±3.07, respectively, all p<0.05. VAS-LBP and ODI 12-month SEA vs control: 1.27±0.74 vs 1.93±0.58, 12.20±1.88 vs 14.43±1.89,respectively, all p<0.05). At 24-month follow-up, both groups showed no difference in fusion rate (83.33% vs 90.00%, p=0.45), while SEA group showed a lower CS rate (13.33% vs 53.33%, p<0.05).
CONCLUSIONS: OLIF-AF-SEA was safe with no adverse effects and resulted in lower CS rate and better sagittal balance. OLIF-AF-SEA is a promising surgical method for treating patients with DLS-OP.
METHODS: 30 patients underwent OLIF-AF-SEA (SEA group) were matched with 30 patients received OLIF-AF (control group), in terms of sex, age, body mass index (BMI) and bone mineral density (BMD). Clinical outcomes including visual analog scale (VAS) score of the lower back pain (VAS-LBP), leg pain (VAS-LP), and Oswestry Disability Index (ODI) were evaluated at different postoperative intervals and comparedwith their preoperative counterparts. Radiographic outcomes such as disk height (DH), slip distance (SD), lumbar lordosis (LL), segmental lordosis (SL), cage subsidence (CS) rate and fusion rate were evaluated at different postoperative intervals and compared with their preoperative counterparts.
RESULTS: SEA group presented to be better at 3-month and 12-month follow-up, the VAS-LBP, VAS-LP and ODI scores of the SEA group were significantly lower than the control group (3-month SEA vs control: 2.30±0.70 vs 3.30±0.75, 2.03±0.72 vs 2.90±0.76,15.60±2.36 vs 23.23±3.07, respectively, all p<0.05. VAS-LBP and ODI 12-month SEA vs control: 1.27±0.74 vs 1.93±0.58, 12.20±1.88 vs 14.43±1.89,respectively, all p<0.05). At 24-month follow-up, both groups showed no difference in fusion rate (83.33% vs 90.00%, p=0.45), while SEA group showed a lower CS rate (13.33% vs 53.33%, p<0.05).
CONCLUSIONS: OLIF-AF-SEA was safe with no adverse effects and resulted in lower CS rate and better sagittal balance. OLIF-AF-SEA is a promising surgical method for treating patients with DLS-OP.
摘要：
目的：评价腰椎斜融合术(OLIF)联合前外侧螺钉固定(AF)及应力终板强化(SEA)与OLIF-AF治疗退行性腰椎滑脱(DLS)伴骨质疏松(OP)的疗效。
方法：30例接受OLIF-AF-SEA（SEA组）的患者与30例接受OLIF-AF（对照组）的患者相匹配，在性方面，年龄,体重指数（BMI）和骨密度（BMD）。临床结果包括下腰痛的视觉模拟量表（VAS）评分（VAS-LBP），腿部疼痛（VAS-LP），和Oswestry残疾指数（ODI）在不同的术后间隔进行评估，并与术前同行进行比较。放射学结果，如磁盘高度（DH），滑移距离(SD),腰椎前凸(LL),节段前凸(SL),在不同的术后间隔评估笼子下沉（CS）率和融合率，并与术前比较。
结果：SEA组在3个月和12个月的随访中表现更好，VAS-LBP，SEA组的VAS-LP和ODI评分明显低于对照组（3个月SEA与对照组：2.30±0.70vs3.30±0.75，2.03±0.72vs2.90±0.76,15.60±2.36vs23.23±3.07，分别所有p<0.05。VAS-LBP和ODI12个月SEA与对照组的比较：分别为1.27±0.74vs1.93±0.58、12.20±1.88vs14.43±1.89，所有p<0.05)。在24个月的随访中，两组融合率无差异(83.33%vs90.00%,p=0.45),而SEA组的CS率较低(13.33%vs53.33%，p<0.05)。
结论：OLIF-AF-SEA是安全的，无不良反应，可降低CS率和更好的矢状平衡。OLIF-AF-SEA是治疗DLS-OP患者的一种有前途的手术方法。
方法：30例接受OLIF-AF-SEA（SEA组）的患者与30例接受OLIF-AF（对照组）的患者相匹配，在性方面，年龄,体重指数（BMI）和骨密度（BMD）。临床结果包括下腰痛的视觉模拟量表（VAS）评分（VAS-LBP），腿部疼痛（VAS-LP），和Oswestry残疾指数（ODI）在不同的术后间隔进行评估，并与术前同行进行比较。放射学结果，如磁盘高度（DH），滑移距离(SD),腰椎前凸(LL),节段前凸(SL),在不同的术后间隔评估笼子下沉（CS）率和融合率，并与术前比较。
结果：SEA组在3个月和12个月的随访中表现更好，VAS-LBP，SEA组的VAS-LP和ODI评分明显低于对照组（3个月SEA与对照组：2.30±0.70vs3.30±0.75，2.03±0.72vs2.90±0.76,15.60±2.36vs23.23±3.07，分别所有p<0.05。VAS-LBP和ODI12个月SEA与对照组的比较：分别为1.27±0.74vs1.93±0.58、12.20±1.88vs14.43±1.89，所有p<0.05)。在24个月的随访中，两组融合率无差异(83.33%vs90.00%,p=0.45),而SEA组的CS率较低(13.33%vs53.33%，p<0.05)。
结论：OLIF-AF-SEA是安全的，无不良反应，可降低CS率和更好的矢状平衡。OLIF-AF-SEA是治疗DLS-OP患者的一种有前途的手术方法。
