A comparison of the bilateral decompression via unilateral approach versus conventional approach transforaminal lumbar interbody fusion for the treatment of lumbar degenerative disc disease in the elderly.
A comparison of the bilateral decompression via unilateral approach versus conventional approach transforaminal lumbar interbody fusion for the treatment of lumbar degenerative disc disease in the elderly.
复制标题
单侧入路双侧减压与常规入路经椎间孔腰椎椎间融合术治疗老年腰椎间盘退变性疾病的比较
DOI：
10.1186/s12891-021-04026-w
复制
发表时间：
2021-02-08
影响因子：
2.3
通讯作者：
Zhou W
中科院分区：
文献类型：
--
作者：
Huang Y;Chen J;Gao P;Gu C;Fan J;Hu Z;Cao X;Yin G;Zhou W
研究背景单侧入路双侧减压术（BDUA）是治疗腰椎退行性疾病的有效手术方法。然而，没有关于预后的研究，特别是软组织的恢复，报告在老年人群中使用BDUA。这些研究的目的是研究通过单侧入路双侧减压与传统入路经椎间孔腰椎椎间融合术（TLIF）治疗65岁以上腰椎退行性椎间盘疾病的早期疗效，方法对61例老年腰椎退行性疾病患者的临床资料进行回顾性分析，回顾性分析手术治疗情况。对31例采用单侧入路双侧减压（BDUA）行腰椎椎体间融合术的患者与30例采用常规入路经椎间孔行腰椎椎体间融合术的患者进行比较。采用X线片测量腰椎前凸角和融合率等影像学参数。采用日本骨科协会（乔亚）、视觉疼痛评分（VAS）和奥斯韦斯特里功能障碍指数（ODI）评分评价不同时间点的临床结局。结果BDUA入路组术中出血量（p< 0.05）和术后引流量（p <0.05）均明显少于常规入路经椎间孔腰椎间融合术组。与术前相比，术后椎管狭窄和神经压迫症状明显缓解。BDUA组术后6个月对侧脂肪变性率（9.42 ± 3.17%）低于减压侧（11.68 ± 3.08%）（P< 0.05）。结论单侧入路双侧减压术（BDUA）可减少老年患者术中、术后的体液丢失。BDUA减压对侧6个月内脂肪变性较轻，提示老年患者软组织恢复较好。
BackgroundBilateral decompression via unilateral approach (BDUA) is an effective surgical approach for treating lumbar degenerative diseases. However, no studies of prognosis, especially the recovery of the soft tissue, have reported using BDUA in an elderly population. The aims of these research were to investigate the early efficacy of the bilateral decompression via unilateral approach versus conventional approach transforaminal lumbar interbody fusion (TLIF) for the treatment of lumbar degenerative disc disease in the patients over 65 years of age, especially in the perioperative factors and the recovery of the soft tissue.MethodsThe clinical data from 61 aging patients with lumbar degenerative disease who received surgical treatment were retrospectively analyzed. 31 cases who received the lumbar interbody fusion surgery with bilateral decompression via unilateral approach (BDUA) were compared with 30 cases who received conventional approach transforaminal lumbar interbody fusion. The radiographic parameters were measured using X-ray including lumbar lordosis angle and fusion rate. Japanese Orthopedic Association (JOA), Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores were used to evaluate the clinical outcomes at different time points. Fatty degeneration ratio and area of muscle/vertebral body were used to detect recovery of soft tissue.ResultsThe BDUA approach group was found to have significantly less intraoperative blood loss(p< 0.05) and postoperative drainage(p < 0.05) compared to conventional approach transforaminal lumbar interbody fusion group. Symptoms of spinal canal stenosis and nerve compression were significantly relieved postoperatively, as compared with the preoperative state. However, the opposite side had a lower rate of fatty degeneration (9.42 ± 3.17%) comparing to decompression side (11.68 ± 3.08%) (P< 0.05) six months after surgery in the BDUA group. While there were no significant differences (P> 0.05) in two sides of conventional transforaminal lumbar interbody fusion approach group six months after surgery.ConclusionsBilateral decompression via unilateral approach (BDUA) is able to reduce the intraoperative and postoperative body fluid loss in the elderly. The opposite side of decompression in BDUA shows less fatty degeneration in 6 months, which indicates better recovery of the soft tissue of the aging patients.
登录
查看更多内容
影响因子：
2.3
作者：
Singh DK;Bailey M;Lee R
通讯作者：
Lee R
影响因子：
1.6
作者：
Jiang, X. Z.;Tian, W.;He, D.
通讯作者：
He, D.
影响因子：
10.7
作者：
Hartle A;McCormack T;Carlisle J;Anderson S;Pichel A;Beckett N;Woodcock T;Heagerty A
通讯作者：
Heagerty A
影响因子：
3.5
作者：
Crawford, R. J.;Filli, L.;Ulbrich, E. J.
通讯作者：
Ulbrich, E. J.
影响因子：
4.5
作者：
Fogel, Guy R.;Toohey, John S.;Brantigan, John W.
通讯作者：
Brantigan, John W.