Objective To Introduce two types of minimally invasive surgery by decompression and interbody fusion for the treatment of lumbar diseases,and summarize the advantages and disadvantages compared with the traditional open technique. Methods 9 patients underwent percutaneous pedicle screw fixation and decompression and interbody fusion through a smalll incision or under microendoscopic discectomy. 38 patients underwent pedicle screw fixation, decompression and interbody fusion through a small incision at both sides of the spinous process by limited and orderly exposed. All patients were followed up at 3,6,12 months after operation. Results Compared with the traditional open technique,there was no statistically significant difference in operative time, blood loss and the fusion rate, but significantly reduced the incidence of Fusion disease "and shorten the time to start early rehabilitation. Conclusion Minimally invasive surgical technique could achieve less local tissue damage,low incidence of'Fusion disease"and rehabilitation exercise.%目的 介绍两种微创手术,通过减压和椎体间融合治疗部分下腰椎退变性疾病,总结该技术相对于传统开放术的利弊.方法 (1)经皮椎弓根螺钉植入+小切口椎板开窗或椎间盘镜下开窗减压,椎间植骨融合术,共9例；(2)小切口棘旁两侧分次有限暴露固定并减压椎间植骨融合术,共38例.所有病例分别于术后3、6、12个月得到随访.结果 本组与传统术式相比,手术时间、出血量及骨性融合率都无显著性差异,但融合病发生率显著降低,术后开始训练时间显著提早.结论 微创化术式可减少局部创伤,提早康复锻炼,降低融合病发生率.
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