Effect of bone mineral density on the clinical efficacy of oblique lateral interbody fusion in the treatment of lumbar degenerative spondylolisthesis
10.3969/j.issn.1004-406X.2023.12.05
- VernacularTitle:骨密度对斜侧方入路椎体间融合术治疗腰椎退行性滑脱症疗效的影响
- Author:
Ming ZENG
1
;
Shiyuan LI
;
Lin YANG
Author Information
1. 广东省佛山市第一人民医院脊柱骨外科 528000
- Keywords:
Lumbar degenerative spondylolisthesis;
Bone mineral density;
Oblique lumbar interbody fusion;
Fusion rate;
Clinical efficacy;
Intervertebral disc height
- From:
Chinese Journal of Spine and Spinal Cord
2023;33(12):1091-1097,1106
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To analyze the clinical effect of bone mineral density(BMD)on the efficacy of oblique lateral interbody fusion(OLIF)in the treatment of lumbar degenerative spondylolisthesis(LDS).Methods:A retrospective analysis was conducted on the clinical data of patients with Meyerding grade Ⅰ LDS who underwent OLIF assisted with a minimally invasive spinal channel system between December 2017 and July 2020.Based on the preoperative BMD,the patients were divided into low bone mass group(-2.5＜T-score＜-1.0,n=30)and osteoporosis group(T-score≤-2.5,n=22).There was no statistical difference between the two groups in gender ratio,age,and segments of spondylolisthesis(P＞0.05).The operative time,intraopera-tive blood loss,ambulation time after surgery,length of hospital stay,and complications were collected and compared between the two groups.The postoperative 1 week reduction rate of spondylolisthesis,and postoper-ative 1 month improvement in spinal canal cross-sectional area,and intervertebral disc height restoration were counted and compared;Bone graft fusion was observed of the two groups of patients on X-ray images at 3 months,6 months,and 12 months of follow-up after operation.The Japanese Orthopaedic Association(JOA)scores were assessed at pre-operation,and 1,3,6 and 12 months after operation,and JO A score at 12 months after operation was used to determine the improvement rate of JOA score.Results:Comparing with the osteoporosis group,the low bone mass group was shorter in operative time(119.5±12.7min vs.163.3± 14.2min),less in intraoperative blood loss(98.9±22.4mL vs.211.5±29.8mL),shorter in ambulation time after surgery(2.3±0.9d vs.3.9±1.2d)and length of hospital stay(6.2±1.3d vs.8.9±1.6d)(P＜0.05).At 1 week postoper-atively,complete reduction was observed in 29 cases(96.7％)in the low bone mass group and 15 cases(68.2％)in the osteoporosis group.There was a statistically significant difference in the reduction outcomes between the two groups(P＜0.05).After OLIF treatment,statistically significant differences were noted between the postopera-tive dural sac cross-sectional area and the intervertebral disc height and the preoperative values,respectively(P＜0.05).The recovery of intervertebral disc height of the osteoporosis group was significant different from that of the low bone mass group(12.79±0.99mm vs.11.25±0.98mm,P＜0.05),while the improvement of the dural sac cross-sectional area was not(P＞0.05).The fusion rates were not significantly different between the two groups(93.3％vs 77.3％,P＞0.05).The JOA scores at 1 month and 3 months after surgery in the low bone mass group were statistically significant different from those of the osteoporosis group(P＜0.05),while the JOA scores at 6 and 12 months after surgery were not significantly different between the two groups(P＞0.05).Conclusions:OLIF can achieve satisfactory short-term clinical outcomes in low bone mass and osteoporosis LDS patients,and its efficacy is better in patients with low bone mass than patients with osteoporosis.
