Original Article
Effect of oblique lateral lumbar intervertebral fusion on inflammatory factors in patients with degenerative spinal canal stenosis
Liu En, Li Kaihua, Lyu Fei, Wang Haibin, Han Qingqing, Zhang Junfen, Chen Ling
Published 2020-03-15
Cite as Int J Surg, 2020,47(03): 181-187. DOI: 10.3760/cma.j.issn.1673-4203.2020.03.008
Abstract
ObjectiveTo investigate the effect of oblique lateral lumbar intervertebral fusion (OLIF) on inflammatory factors in patients with degenerative spinal canal stenosis (DLSS).
MethodsRetrospective analysis of clinical data of 64 DLSS patients in the department of orthopedics, Jizhong Energy Fengfeng Group Hospital from June 2016 to June 2018 was performed. There were 35 males and 34 females, aged (60.70±6.27) years, and the age range was 20 to 80 years. According to the different surgical methods, they were divided into posterior decompression and internal fixation fusion (PLIF) group (n=32) and OLIF group (n=32). The coperation time, intraoperative bleeding volume, postoperative bed rest time, hospitalization time , the back and leg pain visual analogue score (VAS) , Japanese Orthopaedic Association(JOA) score of lumbar vertebrae and serum inflammatory factors [tumor necrosis factor-alpha(TNF-α), interleukin-1alpha(IL-1α), C-reactive protein(CRP)] were observed at preoperative, 3 months and last follow-up. Follow-up using outpatient examination and telephone interview was performed and survial up to March 2019. Measurement data were expressed as mean±standard deviation (Mean±SD), comparison between groups was performed using independent sample t test or analysis of variance of repeated measurement data. Internal comparisons were performed using paired t tests. Count data were expressed as percentage (%), and χ2 test was used.
ResultsThere was no significant difference in operation time between OLIF group and PLIF group (P>0.05). In OLIF group, the amount of blood loss (119.72±30.41) mL, bedridden time (2.16±0.35) d and postoperative hospital stay (5.18±2.06) d were significantly lower than that of PLIF group[(318.26±94.62) mL, (3.17±0.54) d, (7.35±1.24) d], the differences between the two groups were statistically significant(P<0.05). All patients were followed for 8 months. The 3 months after operation and last follow-up, the VAS scores of back pain in OLIF group [(1.93±0.54) scores, (1.74±0.63) scores]were significantly lower than that in PLIF group [(4.05±0.62) scores, (3.87±0.74) scores]. The VAS scores of leg pain in OLIF group [(1.56±0.71) scores, (1.37±0.52) scores] were significantly lower than that of PLIF group [(3.74±0.79) scores, (2.53±0.59) scores]. The JOA scores of lumbar vertebrae in PLIF group [(22.57 ±1.83) scores, (24.38±1.65) scores] were significantly higher than that of PLIF group [(20.35±1.78) scores, (22.14±1.35) scores], the differences between the two groups were statistically significant(P<0.05). At 3 months after operation, the levels of serum TNF-α(16.95±3.92) ng/L, IL-1α(9.17±3.78) ng/L and CRP (1.97±0.24) mg/L in OLIF group were significantly lower than those in PLIF group [(20.46 ±4.27) ng/L, (11.51±4.25) ng/L, (2.36±0.32) mg/L]. Last follow-up, the level of serum TNF-α(13.47±3.54) ng/L, IL-1α(6.52±2.09) ng/L and CRP (1.42±0.16) mg/L in the OLIF group were significantly lower than those in the PLIF group [(18.08±3.84) ng/L, (8.73±5.43) ng/L, (2.04±0.25) mg/L], the differences between the two groups were statistically significant (P<0.05).
ConclusionCompared with PLIF, OLIF can reduce the amount of intraoperative bleeding, shorten the recovery time, reduce the expression of inflammatory factors and improve the prognosis of patients with DLSS.
Key words:
Tumor necrosis factor-alpha; Interleukin-1alpha; C-reactive protein; Oblique lateral lumbar interbody fusion; Degenerative lumbar spinal stenosis
Contributor Information
Liu En
Department of Orthopedics, Jizhong Energy Fengfeng Group Hospital, Handan 056200, China
Li Kaihua
Department of Orthopedics, Jizhong Energy Fengfeng Group Hospital, Handan 056200, China
Lyu Fei
Department of Orthopedics, Jizhong Energy Fengfeng Group Hospital, Handan 056200, China
Wang Haibin
Department of Orthopedics, Jizhong Energy Fengfeng Group Hospital, Handan 056200, China
Han Qingqing
Department of Orthopedics, Jizhong Energy Fengfeng Group Hospital, Handan 056200, China
Zhang Junfen
Department of Orthopedics, Jizhong Energy Fengfeng Group Hospital, Handan 056200, China
Chen Ling
the First People's Hospital of Baiyin, Baiyin 730900, China