背景:外侧腰椎椎间融合术(LLIF)通常用于解决各种腰椎病变。LLIF使用俯卧肌(PTP)方法具有几个潜在的优势,允许同时进入脊柱的前柱和后柱。本研究的目的是通过PTP报告LLIF的1年结局。
方法:这是一项对通过PTP接受LLIF的97例连续患者的回顾性研究。射线照相参数,包括腰椎前凸,节段前凸,前盘高度,和后椎间盘高度,在术前测量,初始-术后,术后1年影像学检查。患者报告的结果指标,包括Oswestry残疾指数,视觉模拟量表(VAS),疼痛EQ5D,和术后并发症,被审查了。
结果:97例连续患者接受了161个LLIF水平。57%的人接受了1级LLIF,30%2级LLIF,6%3级LLIF,和7%的4级LLIF。最常见的水平是L4至L5(35%),其次是L3到L4(33%),L2到L3(21%),L1至L2(11%)。腰椎前凸在最初和术后1年(2°±10°,P=0.049;3°±9°,P=0.005),节段前凸(6°±5°,P<0.001;5°±5°,P<0.001),前盘高度(8mm±4mm,P<0.001;7mm±4mm,P<0.001),和后椎间盘高度(3mm±2mm,P<0.001;3mm±2mm,P<0.001)。在6周时,Oswestry残疾指数显着改善(P=0.002),6个月(P<0.001),术后1年(P<0.001);6周疼痛EQ5D(P<0.001),6个月(P<0.001),术后1年(P<0.001);2周时腿和背部视觉模拟量表(P<0.001),6个月(P<0.001),术后1年(P<0.001)。平均逗留时间为2.5天,最常见的并发症是同侧髋关节屈肌疼痛(46%),弱点(59%),和对侧髋关节屈肌疼痛(29%)。
结论:PTP是进行LLIF的一种新方法。这些1年的数据支持PTP是有效的,安全,和可行的方法,患者报告的结局指标和并发症情况与在侧卧位进行的LLIF相似。
方法:
BACKGROUND: Lateral lumbar interbody fusion (LLIF) is commonly used to address various lumbar pathologies. LLIF using the prone transpsoas (PTP) approach has several potential advantages, allowing simultaneous access to the anterior and posterior columns of the spine. The aim of this study was to report the 1-year outcomes of LLIF via PTP.
METHODS: This is a retrospective review of 97 consecutive patients who underwent LLIF via PTP. Radiographic parameters, including lumbar-lordosis, segmental-lordosis, anterior disc height, and posterior disc height, were measured on preoperative, initial-postoperative, and 1-year postoperative imaging. Patient-reported outcomes measures, including Oswestry Disability Index, visual analog scale (VAS), pain EQ5D, and postoperative complications, were reviewed.
RESULTS: Ninety-seven consecutive patients underwent 161 levels of LLIF. Fifty-seven percent underwent 1-level LLIF, 30% 2-level LLIF, 6% 3-level LLIF, and 7% 4-level LLIF. The most common level was L4 to L5 (35%), followed by L3 to L4 (33%), L2 to L3 (21%), and L1 to L2 (11%). Significant improvements were noted at initial and 1-year postoperative periods in lumbar-lordosis (2° ± 10°, P = 0.049; 3° ± 9°, P = 0.005), segmental-lordosis (6° ± 5°, P < 0.001; 5° ± 5°, P < 0.001), anterior disc height (8 mm ± 4 mm, P < 0.001; 7 mm ± 4 mm, P < 0.001), and posterior disc height (3 mm ± 2 mm, P < 0.001; 3 mm ± 2 mm, P < 0.001). Significant improvements were seen in Oswestry Disability Index at 6 weeks (P = 0.002), 6 months (P < 0.001), and 1 year (P < 0.001) postoperatively; pain EQ5D at 6 weeks (P < 0.001), 6 months (P < 0.001), and 1 year (P < 0.001) postoperatively; and leg and back visual analog scale at 2 weeks (P < 0.001), 6 months (P < 0.001), and 1 year (P < 0.001) postoperatively. The average length of stay was 2.5 days, and the most common complications were ipsilateral hip flexor pain (46%), weakness (59%), and contralateral hip flexor pain (29%).
CONCLUSIONS: PTP is a novel way of performing LLIF. These 1-year data support that PTP is an effective, safe, and viable approach with similar patient-reported outcome measures and complications profiles as LLIF performed in the
lateral decubitus position.
METHODS: