Analysis Of The Curative Effect Of Indirect Decompression With Stand-alone Oblique Lumbar Interbody Fusion In The Treatment Of Lumbar Degenerative Diseases

Objective:To explore the feasibility,safety and surgical efficacy of Stand-alone oblique lateral interbody fusion(Stand-alone OLIF).Clarify the indirect decompression effect of Stand-alone OLIF in the treatment of lumbar degenerative diseases.Method:A retrospective study of the clinical and imaging data of 24 patients with lumbar degenerative diseases who underwent Stand-alone OLIF surgery in the Spine Surgery Research Center of Wannan Medical College,from January 2018 to September2019.There were 13 males and 11 females;the age ranged from 45 to 83(63.00±9.79)years.Record the gender,age,BMI,BMD(T-score),operation time,intraoperative blood loss,surgical segment,length and height of the fusion cage,hospital stay,postoperative hospital stay and other relevant data of all patients.The visual analogue scale(VAS)and the Oswestry disability index(ODI)were used to evaluate the symptoms,signs and neurological function of all patients during preoperative and postoperative follow-up.The lumbar lordosis angle(LLA),disc height(DH),foraminal height(FH),foraminal area(FA),cross-sectional area of the spinal canal(CSAC),coronal spinal canal diameter(ASCD),sagittal spinal canal diameter(SSCD)were measured for all patients before and during follow-up.Results:The average operation time of 24 patients was(76.46±15.35)min,and the average intraoperative blood loss was(48.33±14.03)ml.The average hospital stay was(8.25±1.93)days,the average postoperative hospital stay was(3.54±1.93)days,the average BMI was(25.17±2.82)kg/m~2,and the average BMD(T-score)was-1.00±1.41.There are a total of 24 surgical segments,all of which are L4/5 single-segment.5segments use 10mm cages*50mm cage;1 segments use 10mm*55mm cages;6 segments use 12mm*50mm cages;5 segments use 12mm*55mm cages;2 segments use14mm*50mm cages;5 segments use 14mm*55mm cages.There were 6 segments,11segments,and 7segments using fusion cages with heights of 10mm,12mm,and 14mm.There were 13 segments and 11 segments using fusion cages with lengths of 50mm and55mm.The scores of VAS and ODI improved from(5.33±0.96)and(56.83±12.96)%before surgery to(2.63±0.57)and(30.25±5.73)%at the last follow-up respectively.There were statistically significant differences in the VAS and ODI scores between patients before surgery and at the last follow-up.LLA improved from(29.77±11.13)°before surgery to(41.79±11.04)°at the last follow-up;DH improved from(1.08±0.25)cm before surgery to(1.16±0.25)cm at the last follow-up;FH improved from(1.57±0.25)cm before surgery to(1.66±0.26)cm at the last follow-up;FA improved from(1.20±0.20)cm2before surgery to(1.50±0.19)cm~2 at the last follow-up;CSAC improved from(1.10±0.41)cm~2 before surgery to(1.32±0.43)cm~2 at the last follow-up;ASCD improved from(1.13±0.26)cm before surgery to(1.33±0.25)cm at the last follow-up;SSCD improved from(0.82±0.28)cm before surgery to(1.03±0.28)cm at the last follow-up.There were statistically significant differences in LLA,DH,FH,FA,CSAC,ASCD and SSCD before the operation and at the last follow-up.Conclusion:Stand-alone OLIF is safe,feasible and has good surgical effects in the treatment of lumbar degenerative diseases.The effect of indirect decompression is also very significant.