Clinical Study On The Treatment Of Lumbar Degenerative Diseases With Oblique Lumbar Interbody Fusion(OLIF)

Objectives:To study the application of Oblique Lumbar Interbody Fusion(OLIF)in the treatment of lumbar degenerative diseases,analyze its clinical effect and complications,and summarize its effects,safety,advantages and disadvantages,intervention of postoperative residual symptoms with traditional Chinese Medicine.Methods:From March 2018 to December 2019,130 patients with degenerative diseases of lumbar spine were selected from the Department of orthopedics and traumatology of Jiangsu Province Hospital of traditional Chinese medicine,with an average age of(62.5±10.36),54 males,76 females,86 single segment patients,33 double segment patients,10 three segment patients and 1 four segment patient;35 cases of degenerative lumbar spondylolisthesis,12 cases of Lumbar spondylolisthesis,37 cases of lumbar spinal stenosis,20 cases of lumbar instability,14 cases of discogenic low back pain,6 cases of degenerative lumbar scoliosis and 6 cases of adjacent segment diseases.The operation time,intraoperative hemorrhage,complications and endplate injury were counted,and the changes of disc height and foramen height before and after operation were evaluated by radiography.The clinical results was evaluated by comparing the Visual Analogue Scale(VAS)and the JO A score of the Japanese Orthopedic Association,37 patients with residual symptoms were treated with Huangqi Guizhi Wuwu decoction.The curative effect was evaluated according to the modified Macnab evaluation standard 3 months after operation.Results:The average follow-up time was(158.81±55.97)min,and the average bleeding volume was(47.88±29.02)ml.the VAS score of back pain and leg pain decreased from(7.00±1.58)and(3.74±2.28)to(1.05±0.91)and(0.84±0.77)at the last follow-up(P<0.05),respectively;JOA score increased from(13.00±2.41)before operation to(24.51±1.62)at the last follow-up(P<0.05),Disc Height increased from(9.13±1.80)mm before operation to(13.35±1.36)mm after operation,Foramen Height increased from(15.89±1.85)mm before operation to(20.15±2.07)mm after operation(P<0.05),There were 26 patients had 30 complications,no serious complications such as organ injury,denervation injury and infection.There were 37 patients with residual symptoms were treated with Huangqi Guizhi Wuwu decoction,the effective rate is 89.2%.Conclusions:1.OLIF is a safe,effective and minimally invasive technique,which can treat most of the degenerative lumbar diseases.It can avoid the damage to the posterior column structure of the lumbar spine,avoid disturbing the spinal canal,have less bleeding,less muscle peeling and fast recovery,it conforms to the principle of "emphasis on both sinews and bones".Huangqi Guizhi Wuwu decoction can effectively relieve the residual symptoms after OLIF.2.All kinds of lumbar interbody fusion have their own advantages and can't replace each other.OLIF is not suitable for all kinds of lumbar diseases.Fusion without internal fixation(stand-alone)has certain stability,the recent clinical results are satisfactory.