Clinical Study Of OLIF In The Treatment Of Multi-Segment Degenerative Lumbar Scoliosis

Objective:To investigate the radiological and clinical effects of OLIF in the treatment of multi-segment degenerative lumbar scoliosis.Methods:It is a retrospective study of 30 patients who underwent OLIF after being admitted to the spinal surgery center of the Second Affiliated Hospital of Nanchang University from September 2018 to November 2019 due to degenerative scoliosis,11 males and 19 females,average 63.17±4.31 years old.Record the operation time,the amount of bleeding,the length of hospital stay,and the occurrence of intraoperative and postoperative complications.Collect the preoperative and final follow-up imaging coronal scoliosis Cobb angle,pelvic lumbar spine matching value(Pelvic Incidence-Lumbar Lordosis,PI-LL),sagittal plane balance(Sagittal Aertical Axis,SVA),pelvic tilt angle(Pelvic Tilt,PT)parameters;clinical efficacy assessment using Visual Analogue Scale(VAS)and Oswestry Dability Index(ODI);bone graft fusion rate,etc.Results:All patients successfully completed OLIF combined with internal fixation surgery,it is OLIF in the first phase and pedicle screw internal fixation in the second phase,separated by about 1 week.The average operation time was 189.31±18.16 min,and the intraoperative blood loss was 376.17±33.24 ml.The average length of hospitalization was 13.7±2.1 days.The follow-up time was 6-12 months,with an average of(7.9±3.4)months.(1)Perioperative complications: 1 case of sympathetic nerve chain injury and 1case of segmental arterial injury occurred during operation.After operation,1 case had fusion cage settlement,3 cases had hip flexion,knee weakness,and numbness in front of the thigh.(2)Imaging evaluation: Cobb angle before coronary surgery averaged20.3±3.0°,last follow-up average 5.4±1.4°;preoperative PI-LL 30.7±8.8°,last follow-up average 13.5±1.2°;SVA preoperative 69.9±5.7mm,last follow-up average28.6±4.5mm;preoperative PT23.3 ± 3.2 °,last follow-up average 12.1±6.1 °;P<0.05,all had statistical significance.(3)Clinical efficacy: The average scores of lumbar VAS before operation,1month,3 months and last time are 6.3±1.0,3.2±1.4,1.8±0.6,1.1±0.9 points;lower limb VAS before operation,1 month,3 Monthly and final scores averaged 5.2±0.8,2.8±2.3,1.3±0.2,1.0±0.7 points;ODI preoperative,1 month,3 month,and final scores averaged 32.7±0.4 %,19.1±0.9 %,16.7±2.7 %,14.7±0.3 %.The patient's symptoms were significantly alleviated,P <0.05,all with statistical significance.(4)Bone graft fusion rate: According to the suk standard,all patients have achieved 100% intervertebral fusion.Conclusion:The OLIF treatment of multi-segment degenerative lumbar scoliosis has fewer complications during the perioperative period,improved spinal deformity and obvious clinical efficacy.It is a minimally invasive,effective,and low-risk surgical method,which is worth promoting.