| Objective: To discuss the clinical effect of Oblique Lateral Interbody Fusion(OLIF)in treating Adult Degenerative Scoliosis(ADS).Methods: Sixty-one patients with ADS who were surgically treated in our hospital between March,2017 and December,2020 were included in this study.Patients were divided into two groups according to the surgical approach.The data of blood loss,operation time,the time of getting out of bed,the length of hospital stay,postoperative complication,as well as the Visual Analogue Scale(VAS),Oswestry Disability Index(ODI),coronal thoracic,lumbar Cobb angle,global coronal balance(GCB),lumbar lordosis(LL),pelvic incident(PI),pelvic tilt(PT),Sacral Slope(SS),and sagittal vertical axis(SVA)were reviewed.The differences of clinical results between the two groups were compared and analyzed.Results: Of the 61 patients,29 patients were treated with OLIF and 32 patients were treated with traditional posterior approach.The average age of patients in OLIF group was 59.7±6.3 years.The average age of patients in posterior group was 61.3±7.2 years.There was no significant difference in demographic data between the two groups(P>0.05).The mean operative time of OLIF group was 5.2 ± 1.8 h.The mean operative time of posterior group was 4.7 ± 1.7 h.No significant difference was found between the two groups(P>0.05).The blood loss was 664.7±118.8 m L and 1366.1±176.8 m L in OLIF group and posterior group,respectively,and there was a significant difference between the two groups(P<0.05).The time of getting out of bed was 3.7±0.7 days and 5.4±0.7 days in OLIF group and posterior group,respectively,and there was a significant difference between the two groups(P<0.05).The length of hospital stay was 15.4±3.7 days in OLIF group and 10.8 ± 2.6days in posterior group,and there was a significant difference between the two groups(P<0.05).The preoperative,postoperative,and final follow-up VAS in OLIF group was 5.8±0.8,2.7±0.5 and 1.3±0.8,respectively.The preoperative,postoperative,and final follow-up VAS in posterior group was 6.1±0.8,3.4±0.5 and 1.4±0.7,respectively.The preoperative,postoperative,and final follow-up ODI in OLIF group was 65.5 ± 4.1,35.2 ± 2.1,and 16.7 ± 3.5,respectively.The preoperative,postoperative,and final follow-up ODI in posterior group was 68.7±2.1,42.3±2.9,and 18.9 ± 4.9,respectively.The postoperative VAS and ODI in OLIF group were significantly lower than posterior group.The preoperative,postoperative,and final follow-up SVA in OLIF group was 56.0±25.7 mm,25.0±13.6 mm,and 25.4±14.6mm,respectively.The preoperative,postoperative,and final follow-up SVA in posterior group was 56.0 ± 25.7 mm,25.0 ± 13.6 mm,and 25.4 ± 14.6 mm respectively.Postoperative SVA in both groups were significantly lower than preoperative values(P<0.05).No significant difference was found in LL,SS,PI,PT,and SVA between the two groups preoperatively,postoperatively,and final follow-up.The postoperative coronal thoracic Cobb angle of both groups were significantly lower than preoperative values(P<0.05).The preoperative,postoperative,and final follow-up lumbar Cobb angle in OLIF group was 25.7±5.2°,13.8±4.4°,and 14.2±3.4 °,respectively.The preoperative,postoperative,and final follow-up lumbar Cobb angle in posterior group was 22.9±3.8°,13.4±6.8°,and 14.1±4.4°,respectively.The preoperative,postoperative,and final follow-up GCB in OLIF group was 3.5 ± 1.6 cm,1.4±0.8 cm,and 1.6 ±0.5 cm,respectively.The preoperative,postoperative,and final follow-up GCB in posterior group was 3.9±2.4 cm,1.8±0.7cm,and 1.9 ± 0.6 cm,respectively.The postoperative GCB in both groups was significantly lower than preoperative values(P<0.05).Postoperative complications occurred in four patients in OLIF group and ten patients in posterior group,and there was a significant difference between the two groups(P<0.05).Conclusion: The clinical effect of OLIF in the treatment of adult degenerative scoliosis is satisfactory.Compared with traditional posterior surgery,OLIF has certain advantages in blood loss,operation time and the improvement of function recovery and pain relief. |
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