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目的:探讨腰椎退变性侧凸方向对斜外侧腰椎椎间融合术（oblique lateral lumbar interbody fusion, OLIF）的影响。方法:回顾性分析2017年1月至12月治疗40例腰椎退变性侧凸患者资料，左侧为凸侧20例（左凸组），男5例，女15例，年龄（70.62±5.45）岁；左侧为凹侧20例（左凹组），男3例，女17例，年龄（69.73±7.24）岁；另纳入不伴侧凸的腰椎退变性疾病（腰椎管狭窄症13例，腰椎间盘突出症7例）患者20例（无侧凸组），男5例，女15例，年龄（71.48±5.73）岁。分别在MR轴位T2加权图像及腰椎正位X线片上测量以下OLIF操作相关解剖学参数：腹主动脉左侧缘至左侧腰大肌前内侧缘距离，腹主动脉左侧缘至左侧腰椎交感干距离，左侧腰大肌前内侧缘至椎体横轴的距离，Ln 2~5相邻椎体中点之间距离，椎体旋转角度，OLIF操作通道角度。对3组测量参数行单因素方差分析及最小显著差异分析。n 结果:3组患者Ln 2，3、Ln 3，4、Ln 4，5节段腹主动脉左侧缘至左侧腰大肌前内侧缘距离和腹主动脉左侧缘至左侧腰椎交感干距离均存在明显统计学差异（均n P<0.05），其中左凹组Ln 2，3节段[（24.41±9.54）mm、（18.18±7.1）mm）]、Ln 3，4节段[（18.54±7.94）mm、（13.73±6.73）mm）]显著大于无侧凸组；而左凸组Ln 4，5节段的上述数值[（19.16±7.04）mm、（11.67±3.63）mm]大于无侧凸组。左侧腰大肌前内侧缘至椎体横轴的距离，左凸组Ln 2，3、Ln 3，4节段[（13.76±2.98）mm、（15.87±3.53）mm]显著大于无侧凸组；而左凹组对应数值[（9.97±3.14）mm、（10.75±5.03）mm]明显小于无侧凸组。左凸组Ln 2，3、Ln 3，4相邻椎体中点之间距离[（37.67±3.45）mm、（38.18±3.54）mm]大于无侧凸组与左凹组，且三组之间差异均有统计学意义（均n P<0.05）。椎体旋转角度与OLIF手术通道角度行Pearson相关性分析显示，在左凸组中两者呈负相关，在左凹组中两者的绝对值呈正相关。n 结论:腰椎退变性侧凸方向对OLIF的手术操作相关解剖学参数具有显著影响，建议术前根据侧凸方向针对性设计并调整操作技巧。“,”Objective:To investigate the operational impact of the curve laterality of degenerative lumbar scoliosis on oblique lateral lumbar interbody fusion (OLIF).Methods:Data of 40 cases with degenerative lumbar scoliosis and 20 cases without degenerative lumbar scoliosis treated in our hospital from January to December 2017 were retrospectively analyzed. There were 20 cases in left convex group (male 5, female 15, 70.62±5.45 years old) and 20 cases in left concave group (male 3, female 17, 69.73±7.24 years old), and there were 20 cases of lumbar degenerative diseases without scoliosis (lumbar spinal stenosis 13 cases, lumbar disc herniation 7 cases; male 5, female 15, 71.48±5.73 years old). The following OLIF operation-related anatomical parameters were measured on MR axial T2 weighted image and lumbar spine X-ray image: distance from the left edge of the abdominal aorta to the anterior medial edge of the left psoas muscle; distance from the left edge of the abdominal aorta to the left lumbar sympathetic trunk; distance from the anterior medial edge of the left psoas muscle to the transverse axis of the vertebral body; distance between the midpoints of adjacent vertebral bodies in Ln 2-5; angle of rotation of the vertebral body and angle of the OLIF operating channel. One-way analysis of variance(ANOVA) and least significant difference (LSD) were used for statistical analysis of measurement parameters of different groups.n Results:There were statistically significant differences between the distance from the left edge of the abdominal aorta to the anterior medial edge of the left psoas muscle, and the distance from the left edge of the abdominal aorta to the left lumbar sympathetic trunk in the three groups of cases (All n P<0.05). The Ln 2, 3 segment (24.41±9.54 mm, 18.18±7.1 mm) and Ln 3, 4 segment (18.54±7.94 mm, 13.73±6.73 mm) in the left concave group were significantly larger than those in the no scoliosis group; and the above values of the Ln 4, 5 segment of the left convex group (19.16±7.04 mm, 11.67±3.63 mm) were significantly larger than those in the no scoliosis group. For the distance from the anterior medial edge of the left psoas muscle to the transverse axis of the vertebral body, the values of Ln 2, 3 and Ln 3, 4 (13.76±2.98 mm, 15.87±3.53 mm) in the left convex group were significantly greater than those in the no scoliosis control group; but in the left concave group, the corresponding values (9.97±3.14 mm, 10.75±5.03 mm) were significantly smaller than those in the no scoliosis group. The distances between the midpoints of adjacent vertebral bodies of Ln 2, 3 and Ln 3, 4 (37.67±3.45 mm, 38.18±3.54 mm) in the left convex group were greater than those in the no scoliosis group and left concave group, and the differences between the three groups were statistically significant (n P<0.05). Pearson correlation analysis between the absolute value of vertebral rotation angle and OLIF surgical passage angle showed that there was a negative correlation between them in the left convex group and a positive correlation in the left concave group.n Conclusion:The curve laterality of degenerative lumbar scoliosis had a certain influence on the anatomical parameters of oblique lateral lumbar interbody fusion. It was recommended to design and adjust the operation skills according to the curve laterality before surgery.