Patel Vishal C, Park Daniel K, Herkowitz Harry N
Department of Orthopaedic Surgery, William Beaumont Hospital, 3601 West 13 Mile Road, Royal Oak, MI 48073, USA.
ScientificWorldJournal. 2012;2012:893608. doi: 10.1100/2012/893608. Epub 2012 Nov 6.
Spinal fusion historically has been used extensively, and, recently, the lateral transpsoas approach to the thoracic and lumbar spine has become an increasingly common method to achieve fusion. Recent literature on this approach has elucidated its advantage over more traditional anterior and posterior approaches, which include a smaller tissue dissection, potentially lower blood loss, no need for an access surgeon, and a shorter hospital stay. Indications for the procedure have now expanded to include degenerative disc disease, spinal stenosis, degenerative scoliosis, nonunion, trauma, infection, and low-grade spondylolisthesis. Lateral interbody fusion has a similar if not lower rate of complications compared to traditional anterior and posterior approaches to interbody fusion. However, lateral interbody fusion has unique complications that include transient neurologic symptoms, motor deficits, and neural injuries that range from 1 to 60% in the literature. Additional studies are required to further evaluate and monitor the short- and long-term safety, efficacy, outcomes, and complications of lateral transpsoas procedures.
从历史上看,脊柱融合术已被广泛应用,最近,经腰大肌外侧入路治疗胸腰椎已成为实现融合的一种越来越常见的方法。关于这种入路的最新文献阐明了其相对于更传统的前路和后路入路的优势,包括组织解剖范围更小、潜在失血量更低、无需额外的手术医生以及住院时间更短。该手术的适应症现已扩大到包括椎间盘退变疾病、椎管狭窄、退变性脊柱侧弯、骨不连、创伤、感染和低度腰椎滑脱。与传统的前路和后路椎间融合术相比,外侧椎间融合术的并发症发生率即使不更低也相似。然而,外侧椎间融合术有独特的并发症,包括短暂性神经症状、运动功能障碍和神经损伤,文献报道的发生率在1%至60%之间。需要进一步的研究来进一步评估和监测经腰大肌外侧手术的短期和长期安全性、有效性、疗效和并发症。