摘要
目的探讨经神经根孔入路腰椎融合术(transforam inal lumbar interbody fusion,TLIF)治疗腰椎间盘突出症伴腰椎不稳的手术方法及疗效。方法对26例腰椎间盘突出伴腰椎不稳患者行TLIF。采用经神经根孔后壁的扩大椎板间开窗、髓核摘除和彻底减压,椎间隙前1/3植入碎骨,后2/3植入单个融合器,同时使用经椎弓根螺钉系统固定脊柱。效果平均手术时间2(1.5～4)h;术中平均出血量250(100～450)ml。随访1.5(1～2)年,所有患者脊柱节段均获融合(100%),平均融合时间为8(6～11)个月。术后症状均有不同程度改善,优良率为96.2%(25/26)。结论TLIF治疗伴有腰椎不稳的椎间盘突出具有手术简单、创伤小、融合率高和效果好等优点。
Objective To investigate the technique, effect and indications of transforaminal lumbar interbody fusion （TLIF） for lumbar disc herniation with spinal instability. Methods Twenty-six patients of lumbar disc herniation with spinal instability had been operated on with TLIF. An extended inter-laminal fenestration via transforaminal approach was applied, followed by complete removal of the disc and decompression. Graft chips were implanted into the anterior 1/3 and a single fusion cage was placed in the posterior 2/3. Screw fixation system was applied to strengthen the stability of the spine. Results Operating time was 1.5 ～ 4 hours （mean 2 hours） and blood loss was 100 ～450 ml （mean 250 ml）. The average follow-up was 1.5 years. Fusion occurred in all patients within 6 ～ 11 months （ average 8 months）. 96.2% of the patients had an excellent and good improvement. Conclusions TLIF in the treatment for lumbar disc herniation with spinal instability demonstrates the advantages of simple, less invasive, higher fusion rate and improved effect.
出处
《中国现代手术学杂志》
2005年第4期299-301,共3页
Chinese Journal of Modern Operative Surgery
关键词
椎间盘移位
腰椎
经神经根孔腰椎融合术
intervertebral disk displacement
lumbar vertebrae
transforaminal lumbar interbody fusion（TLIF）
