Oblique lateral interbody fusion of 3D printed lateral fusion cage combined with percutaneous pedicle screw fixation for lumbar spondylolisthesis / 西安交通大学学报(医学版)

ABSTRACT

【Objective】 To discuss the early clinical effect of percutaneous pedicle screw fixation combined with oblique lateral interbody fusion（OLIF） of 3D printed lateral fusion cage for lumbar spondylolisthesis. 【Methods】 Total 21 patients with lumbar spondylolisthesis were enrolled in our study during September 2018 to August 2020. All the patients were treated with percutaneous pedicle screw fixation combined with OLIF of 3D printed lateral fusion cage. The time of operation， blood loss and complications were recorded. Clinical symptoms including low back pain and leg pain were evaluated using a visual analog scale （VAS）， the Oswestry disability index （ODI）， and the MOS item short from health survey （SF-36） before，1 week， and 6 months after surgery. CT and MRI images were evaluated before， 1 week， and 6 months after surgery. Disk height， interforaminal height， degree of upper vertebral slip and intervertebral fusion were evaluated with CT. Sagittal and axial diameters and cross-sectional areas of the spinal canal were evaluated with MRI. 【Results】 The average operation time of all the patients was （110.0±22.8） min， and the average intraoperative blood loss was （56.8±21.6） mL. All the patients were followed up 6 months after operation. The VAS score of lower back pain， VAS score of leg pain and ODI decreased from （6.8±1.6）， （5.6±1.8） and （57.6±13.4）% to （1.5±1.0）， （1.5±0.9） and （13.1±5.2）%， respectively. The differences were statistically significant （P<0.001）. The PCS and MCS scores of SF-36 increased statistically significantly from （27.3±11.8） and （52.4±14.6） before operation to （57.6±10.5） and （76.1±12.0） at follow-up， respectively （P<0.001）. Six months after operation， the height of intervertebral space， the height of intervertebral foramen， the percentage of slip， the sagittal diameter and axial diameter， and cross-sectional area of spinal canal were significantly different from those before operation （P<0.001）. Six months after operation， the fusion rate of the upper and lower interfaces of the 3D printed interbody fusion cage was 100%. There were no serious complications such as nerve or vascular injury after operation. 【Conclusion】 Posterior minimally invasive pedicle screw reduction and fixation technique combined with oblique lateral approach implantation of 3D printing lateral fusion cage in the treatment of lumbar spondylolisthesis has satisfactory early clinical results. This technique can provide a new choice for minimally invasive treatment of lumbar spondylolisthesis.