Javernick Matthew A, Kuklo Timothy R, Polly David W
Department of Orthopaedic Surgery, Walter Reed Army Medical Center, Washington, DC, USA.
Am J Orthop (Belle Mead NJ). 2003 Jul;32(7):344-8; discussion 348.
We conducted a study to quantify the attainable cross-sectional area available for fusion and the mean volume of disk removed with a unilateral transforaminal lumbar interbody fusion (TLIF). Starting with the unilateral approach and completing the procedure with a bilateral approach, we removed the maximal amount of disk material. Postoperative computed tomography (CT) images were used to estimate the cross-sectional area/vertebral endplate available for bone grafting and fusion. Results showed that, using the unilateral approach, we removed 11.8 cm3 (range, 7-25 cm3) of disk material--or more than 69% of the total volume of resected disk. Postoperative CT images confirmed that more than 56% of the endplate cross-sectional area is available for fusion using the unilateral approach. We conclude that unilateral TLIF removes sufficient disk material for achieving a solid and stable arthrodesis while minimizing neural retraction and dural exposure.
我们开展了一项研究，以量化单侧经椎间孔腰椎椎间融合术（TLIF）可实现的融合横截面积以及切除椎间盘的平均体积。从单侧入路开始，并用双侧入路完成手术，我们切除了最大量的椎间盘组织。术后计算机断层扫描（CT）图像用于估计可用于植骨和融合的横截面积/椎体终板。结果显示，采用单侧入路时，我们切除了11.8立方厘米（范围为7 - 25立方厘米）的椎间盘组织，即超过切除椎间盘总体积的69%。术后CT图像证实，采用单侧入路时，超过56%的终板横截面积可用于融合。我们得出结论，单侧TLIF切除了足够的椎间盘组织以实现牢固稳定的椎间融合，同时将神经牵拉和硬脊膜暴露降至最低。
