To Evaluate The Early Clinical Effect Of Both Oblique Lumbar Interbody Fusion And Posterior Lumbar Interbody Fusion To First-degree And Single-segment Degenerative Lumbar Spondylolisthesis

Objectives:(1)The early clinical efficacy of Posterior lumbar interbody fusion(PILF)and Oblique lumbar interbody fusion(OLIF)in the treatment of single-segment degenerative lumbar spondylolisthesis grade I was systematically compared.By integrating relevant evidence,the advantages and disadvantages of the two groups of surgical methods were compared,so as to obtain a surgical scheme with better efficacy for this disease and guide clinical practice.(2).Using statistical analysis to obtain evidence-based medical evidence;Methods: Thirty-four surgical patients with definite diagnosis in our hospital who met the inclusion and exclusion criteria of this study were selected for retrospective analysis.The time interval is 2017.02.01-2018.11.01.In group A,15 cases were OLIF group,and in group B,19 cases PLIF group.Preoperative and postoperative self-comparisons were made between the two groups,and preoperative and postoperative comparisons were made between the two groups to compare perioperative data: incision length,operation time,intraoperative blood loss,postoperative bed time,postoperative hospitalization time;Oswestry disability index(ODI)、 JOA score of Japanese orthopedic association for lower back pain(JOA),visual analogue score(VAS)before surgery,2 weeks after surgery,3 months after surgery and 6 months after surgery;Preoperatively and 6 months after surgery,the evaluation of the manual muscle test of the lumbar dorsal muscle(MMT)was performed;Early postoperative complications: nerve root injury,dural sac injury,intervertebral space infection,abdominal blood vessels,viscera injury,sympathetic stem injury,endplate fracture,fusion device displacement,etc.;Macnab standard score for lumbago and back pain surgery in 6 months after surgery;Results:All the 34 patients completed the operation successfully.The perioperative data of OLIF group(incision length,operation time,intraoperative blood loss,postoperative bed rest time,postoperative hospital stay time)were significantly shorter than that of PLIF group,and the difference was statistically significant(P < 0.05).In the OLIF group,no nerve root injury,dural sac rupture,endplate fracture,and abdominal organ damage occurred.One case presented bilateral difference in temperature sensation of the lateral lower limbs,which was relieved 1 week after surgery.PLIF group included 1 patient with nerve root injury,and lower limb sensory recovery 6 months after surgery.The incidence of early severe complications in OLIF group was significantly lower than that in PLIF group,and the difference was statistically significant(P < 0.05).VAS scores of the two groups were significantly different 2 weeks after surgery(P < 0.05),and the OLIF group was significantly superior to the PLIF group.Oswestry disability index(ODI)at 6 months after surgery and Macnab at 6 months after surgery were both improved compared with those before surgery,with statistically significant differences(P < 0.05),but no statistically significant differences were found between the two groups(P > 0.05).34 patients were followed up for 5-9 months,with an average follow-up of 6.5 0.74 months.ODI,VAS and JOA scores of the two groups at 6 months after surgery were significantly lower than those before surgery(P < 0.05),but the difference between the two groups was not statistically significant(P > 0.05).Conclusions: OLIF surgery is as effective as PLIF surgery in the treatment of grade I lumbar spondylolisthesis with single-segment degeneration,but OLIF has incomparable early clinical efficacy,that is,short incision,less intraoperative blood loss,short postoperative bed rest time,short postoperative hospital stay,short-term relief of patients’ pain symptoms,and high patient acceptance.It has wide clinical application value and prospect.