Marotta Nicola, Cosar Murat, Pimenta Luiz, Khoo Larry T
Division of Neurosurgery, University of California at Los Angeles, California, USA.
Neurosurg Focus. 2006 Jan 15;20(1):E9. doi: 10.3171/foc.2006.20.1.10.
The authors describe a new paracoccygeal approach to the L5-S1 junction for interbody fusion with transsacral instrumentation. The purpose of this technical note is to demonstrate a novel surgical approach, technique, and instrumentation system for the treatment of L5-S1 instability in degenerative disc disease and spondylolisthesis.
This technical note highlights the AxiaLif (TranS1) transsacral system as an alternative method to transforaminal lumbar interbody fusion or posterior lumbar interbody fusion. Via a novel presacral approach corridor, a truly percutaneous L5-S1 discectomy, interbody distraction, and fixation are achieved, and retroperitoneal viscera and dorsal neural elements are avoided. Percutaneous pedicle screw fixation is then used to provide additional stabilization at the treated level.
This novel technique of interbody distraction and fusion via a truly percutaneous approach corridor allows for circumferential treatment of the lower lumbar segments with minimal risk to the anterior organs and dorsal neural elements.
作者描述了一种用于经骶骨器械进行椎间融合的L5-S1关节突旁新入路。本技术说明的目的是展示一种用于治疗退行性椎间盘疾病和腰椎滑脱中L5-S1不稳的新型手术入路、技术和器械系统。
本技术说明强调AxiaLif（TranS1）经骶骨系统作为经椎间孔腰椎椎间融合术或后路腰椎椎间融合术的替代方法。通过一条新的骶前入路通道，可实现真正的经皮L5-S1椎间盘切除术、椎间撑开和固定，同时避免腹膜后脏器和背侧神经结构。然后使用经皮椎弓根螺钉固定在治疗节段提供额外的稳定性。
这种通过真正的经皮入路通道进行椎间撑开和融合的新技术能够以对前方器官和背侧神经结构的最小风险对下腰椎节段进行环形治疗。
