Park Sung Hun, Park Woo Min, Park Cheul Woong, Kang Kwan Soo, Lee Young Keun, Lim Sang Rak
Department of Neurosurgery, Daejeon Woori Spine Hospital, Seo-gu, Daejeon, South Korea.
J Neurosurg Spine. 2009 Jun;10(6):610-6. doi: 10.3171/2009.2.SPINE08360.
The purpose of this study was to determine whether anterior lumbar interbody fusion (ALIF) followed by percutaneous translaminar facet screw fixation is effective in elderly patients with degenerative spinal disease.
Twenty-nine patients > 60 years old who underwent ALIF with percutaneous translaminar facet screw fixation from January to June 2004 were studied. The radiological and clinical data of these patients were collected and analyzed. The mean follow-up period was 14.6 months (range 12-17 months).
The mean preoperative, immediate postoperative, and 6- and 12-month postoperative posterior disc heights were 7.1, 11.6, 9.8, and 9.8 mm, respectively. Subsidences of posterior disc height > 20% developed in 9 patients (30%). The significant risk factor for subsidence was found to be 2-level operations (p = 0.023). The mean preoperative Oswestry Disability Index score and visual analog scale scores for the back and leg were 24.4, 6.6, and 7.5, respectively, and improved postoperatively to 14.2, 1.5, and 1.8, respectively.
Minimally invasive ALIF followed by percutaneous translaminar facet screw fixation was performed as a minimally invasive surgical technique in elderly patients. However, in certain circumstances such as multilevel operations or in patients with severe osteoporosis, significant cage subsidence can develop.
本研究旨在确定老年退行性脊柱疾病患者行前路腰椎椎间融合术（ALIF）后再行经皮椎板间关节突螺钉固定是否有效。
对2004年1月至6月间接受ALIF并经皮椎板间关节突螺钉固定的29例60岁以上患者进行研究。收集并分析这些患者的影像学和临床数据。平均随访期为14.6个月（范围12 - 17个月）。
术前、术后即刻、术后6个月和12个月时的平均后椎间盘高度分别为7.1、11.6、9.8和9.8mm。9例患者（30%）出现后椎间盘高度沉降>20%。发现沉降的显著危险因素为二级手术（p = 0.023）。术前Oswestry功能障碍指数评分以及背部和腿部的视觉模拟量表评分分别平均为24.4、6.6和7.5，术后分别改善至14.2、1.5和1.8。
微创ALIF联合经皮椎板间关节突螺钉固定作为一种微创手术技术应用于老年患者。然而，在某些情况下，如多节段手术或严重骨质疏松患者中，可能会出现明显的椎间融合器沉降。
