A Comparative Study On The Treatment Of Lumbar Degenerative Diseases By The Combination Of Oblique Lateral Interbody Fusion With Posterior Pedicle Screw Fixation And The Single Oblique Lateral Interbody Fusion

Objective: To compare the short-term clinical effect of oblique lateral interbody fusion combined with posterior pedicle screw fixation and oblique lateral interbody fusion alone in the treatment of lumbar degenerative diseases.Methods: The clinical data of 34 patients with lumbar degenerative diseases admitted to spine surgery of the Third Hospital of Hebei Medical University from April 2018 to April 2019 were analyzed retrospectively.30 patients(more than 6 months after operation)were included in this study.According to the different operation methods,the patients were divided into two groups: the single oblique lateral interbody fusion group(stand alone group,13 cases)and the oblique lateral interbody fusion combined with posterior lumbar pedicle screw internal fixation group(olif + PPSF group,17 cases).The clinical data of the two groups were reviewed,The imaging results of the two kinds of operation were compared,including the ventral height of the intervertebral disc,the dorsal height of the intervertebral disc,the height of the intervertebral foramen,the anterior and posterior diameter of the intervertebral foramen,the area of the intervertebral foramen,and the subsidence of the intervertebral fusion cage.The Oswestry disability index(Oswestry disability index)was used Index V,ODI and vas were used to evaluate the improvement of postoperative clinical effect,and CT was used to evaluate the short-term postoperative interbody fusion of the two groups.Results: All patients in this study were followed up for an average of 7.8(6-9)months.Three days after operation,three months after operation and six months after operation,the ventral height of the intervertebral disc,the dorsal height of the intervertebral disc,the height of the intervertebral foramen,the area of the intervertebral foramen,the VAS score and the ODI index in the last follow-up were all higher than those before operation,the difference was statistically significant(P < 0.05);the anterior and posterior diameters of the intervertebral foramen were slightly higher than those before operation,but the difference was not statistically significant(P > 0.05).The cost of auxiliary posterior lumbar internal fixation was higher than that of single oblique approach(P < 0.05).The results showed that 15.3% of stand alone group achieved level 1 fusion,46.1% achieved level 2 fusion,38.4% achieved level 3 fusion,while in olif +PPSF group,level 1 fusion was 17.6%,level 2 fusion was 70.5%,level 3 fusion was 11.7%,the difference was statistically significant(P < 0.05).In the stand alone group,the subsidence degree of the fusion cage at 3 and 6 months after operation was higher than that immediately after operation(P < 0.05),but there was no significant change at 3 and 6 months after operation(P > 0.05);in the olif +PPSF group,there was no significant collapse at 3 and 6 months after operation(P > 0.05).Conclusion: The short-term clinical effect of the two kinds of operation is similar,which has obtained satisfactory surgical effect for the treatment of lumbar degenerative diseases.To some extent,the oblique lateral interbody fusion combined with posterior lumbar pedicle screw internal fixation is more effective than the oblique lateral interbody fusion alone in restoring the intervertebral height,providing anterior column support and mechanical stability,preventing the collapse of the fusion cage,and It is more conducive to promote bone graft fusion.Our follow-up time is relatively short,and the sample size is relatively small.For the long-term effect,further research and observation are needed.