腰椎融合术是脊柱外科中最常见的手术之一。对于其实施,前外侧(腰大前)入路(斜腰椎椎间融合术,OLIF)由于其高疗效和安全性,现在越来越多地使用。然而,关于使用该技术的临床和放射学结果的信息仍然很少。该研究的目的是分析文献中提出的OLIF治疗腰椎疾病的安全性和有效性。
使用OvidMedline进行了系统的电子搜索,PubMed,还有ELIBRARY.RU电子数据库。使用了以下搜索关键字:斜腰椎椎间融合,OLIF,腰大前腰椎椎间融合术,和ATP。
最后分析,选择了17个来源;共有2900名患者。总并发症发生率为13.9%(403例)。严重持续性并发症的发生率小于1%。根据获得的数据,我们比较了OLIF与其他腰椎融合方法的临床和放射学结果。
OLIF是一种有效的,多才多艺,和微创腰椎融合术的选择,并发症相对较少,这使得它优于其他腹膜后方法。然而,OLIF技术并非完全没有与腹侧入路相关的并发症,它不能在所有情况下提供足够的椎管减压。此外,在脊柱畸形的情况下,前路手术的应用仍然有限;主要结合后路手术可以实现适当的畸形矫正。
Lumbar spinal fusion is one of the most common operations in spinal surgery. For its implementation, anterolateral (pre-psoas) approach (oblique lumbar interbody fusion, OLIF) is now increasingly used due to its high efficacy and safety. However, there is still little information on the clinical and radiological results of using this technique. The aim of the study was to analyze the safety and efficacy of OLIF in the treatment of lumbar spine disorders as presented in the literature.
The systematic electronic search was performed using the Ovid Medline, PubMed, and eLIBRARY.RU electronic databases. The following search key words were used: Oblique Lumbar Interbody Fusion, OLIF, Anterior to Psoas Lumbar Interbody Fusion, and ATP.
For the final analysis, 17 sources were selected; with a total of 2900 patients. Total complication rate was 13.9% (403 cases). The incidence of severe persistent complications was less than 1%. Based on the data obtained, we compared the clinical and radiological results of OLIF with other lumbar fusion methods.
OLIF is an effective, versatile, and minimally traumatic option for lumbar fusion with relatively few complications, which makes it superior to other retroperitoneal approaches. However, the OLIF technique is not completely free of complications associated with the ventral approach, and it cannot provide adequate decompression of the spinal canal in all cases. In addition, anterior approach surgery is still of limited use in cases of spinal deformities; adequate correction of deformity is achievable mainly in combination with posterior surgery.