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A minimally invasive posterior lumbar interbody fusion for degenerative lumbar spine instabilities

机译:腰椎后路椎间融合器微创治疗退行性腰椎不稳

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摘要

Percutaneous techniques may be helpful to reduce approach-related morbidity of conventional open surgery. The aim of the study was to evaluate the feasibility and safety of mini-open posterior lumbar interbody fusion for instabilities and degenerative disc diseases. From May 2005 until October 2008, 20 patients affected by monosegmental instability and disc herniation underwent mini-open lumbar interbody fusion combined with percutaneous pedicle screw fixation of the lumbar spine. Clinical outcome was assessed using the Visual Analog Scale, Oswestry Disability Index, and Short Form Health Survey-36. The mean follow-up was 24 months. The mean estimated blood loss was 126 ml; the mean length of stay was 5.3 days; the mean operative time was 171 min. At 24-month follow-up, the mean VAS score was 2.1, mean ODI was 27.1%, and mean SF-36 was 85.2%. 80 screws were implanted in 20 patients. 74 screws showed very good position, 5 screws acceptable, and 1 screw unacceptable. A solid fusion was achieved in 17 patients (85%). In our opinion, mini-open TLIF is a valid and safe treatment of lumbar instability and degenerative disc diseases in order to obtain faster return to daily activities.
机译:经皮技术可能有助于减少常规开放手术的入路相关发病率。该研究的目的是评估微型开放性后路腰椎椎体间融合治疗不稳定性和退行性椎间盘疾病的可行性和安全性。从2005年5月至2008年10月,对20例单节段不稳和椎间盘突出症患者进行了微型开放式腰椎椎体间融合术并经皮椎弓根螺钉固定腰椎。使用视觉模拟量表,Oswestry残疾指数和简短健康调查表36评估临床结局。平均随访时间为24个月。平均估计失血量为126毫升。平均住院时间为5.3天;平均手术时间为171分钟。在24个月的随访中,平均VAS评分为2.1,平均ODI为27.1%,平均SF-36为85.2%。 20例患者植入了80颗螺钉。 74颗螺钉显示出很好的位置,其中5颗螺钉可以接受,而1颗螺钉则不能接受。 17例患者(85%)实现了牢固融合。我们认为,迷你开放式TLIF是一种有效而安全的腰椎不稳和退行性椎间盘疾病治疗,可以更快地恢复日常活动。

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