补阳还五汤对单纯斜前方入路腰椎椎间融合术后早期融合器沉降的影响OA

Objective To evaluate whether Buyang Huanwu Decoction(BYHWD)influences early fusion cage subsid-ence after stand-alone oblique lumbar interbody fusion(SA-OLIF).Methods Forty-two patients undergoing SA-OLIF were randomized by random-number table into two equal groups(n=21 each).The control group underwent SA-OLIF alone;the treatment group received BYHWD in addition to SA-OLIF.Clinical outcomes,including visual analogue scale(VAS)for low back and unilateral lower-limb pain and the Oswestry Disability Index(ODI),were assessed preoperatively,at postoperative day 7,and at postoperative 3 months.Radiographic intervertebral disc height(DH)was measured preoperatively,at postoperative day 3,and at postoperative 3 months to evaluate cage subsidence.Systemic inflammatory markers(white blood cell count[WBC],neutrophil percentage[NEUT%],and C-reactive protein[CRP])were recorded on the day of surgery and at postop-erative days 3 and 7.Adverse events were monitored.Results The treatment group achieved an overall effective rate of 95.24%(20/21)versus 71.43%(15/21)in the control group(P<0.05).Both groups demonstrated significant improvements in VAS and ODI at postoperative day 7 and at 3 months versus baseline(P<0.05),with further improvement at 3 months compared with day 7(P<0.05).The treatment group showed significantly lower VAS and ODI scores than the control group at both postoperative day 7 and 3 months(P<0.05).DH increased significantly in both groups at postoperative day 3 and at 3 months compared with preoperative measurements(P<0.05);however,DH at 3 months and the magnitude of DH improvement were significantly greater in the treatment group than in the control group(P<0.05).At 3-month follow-up,the treatment group had a lower rate of grade I cage subsidence and a smaller subsidence height compared with the control group(both P<0.05).WBC,NEUT%,and CRP decreased at postoperative days 3 and 7 relative to the day of sur-gery in both groups(P<0.05);these inflammatory markers at days 3 and 7 were significantly lower in the treatment group than in the control group(P<0.05).No adverse reactions were observed in either group.Conclusion Adding BYHWD to SA-OLIF sig-nificantly reduces early postoperative fusion cage subsidence,provides greater relief of low back and leg pain,and attenuates postoperative inflammatory markers.