Kwon Dae-Woong, Kim Kyung-Hyun, Park Jeong-Yoon, Chin Dong-Kyu, Kim Keun-Su, Cho Young-Eun, Kuh Sung-Uk
Department of Spinal Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University Collegeof Medicine, 712, Eonjuro, Gangnam-gu, Seoul, Republic of Korea.
Childs Nerv Syst. 2013 Aug;29(8):1339-44. doi: 10.1007/s00381-013-2088-6. Epub 2013 Apr 2.
The posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) techniques are commonly used surgical methods for wide indications such as degeneration or trauma. Although they are rarely required for lumbar disk disease in younger patients, there are a few children and adolescents who are indicated for PLIF or TLIF for other reasons, such as congenital severe stenosis with or without lumbar instability that requires wide decompression or severe bony spur that need to be removed. In such cases, different pathophysiology and outcomes are expected compared with adult patients.
We retrospectively reviewed data of 23 patients who underwent PLIF or TLIF surgery when less than 20 years old. Clinical and radiographic outcomes were assessed during a mean of 36.4 months follow-up period. The indications of lumbar interbody fusion, success of fusion, complications, and visual analog scale (VAS) were analyzed.
Radiographs of all patients taken 6 months after the surgery showed fusion. Clinical outcome was also satisfactory, with improvement of VAS score from 7.7 preoperatively to 2.3 at 6 months after surgery. Only one patient had reoperation due to adjacent segment disease.
For adolescent patients with severe bony spur, massive central disk rupture, or severe spondylolisthesis, lumbar interbody fusion surgery has good surgical outcome with few complications.
腰椎后路椎间融合术（PLIF）和经椎间孔腰椎椎间融合术（TLIF）是常用于治疗退变或创伤等多种适应证的手术方法。虽然年轻患者的腰椎间盘疾病很少需要这些手术，但仍有一些儿童和青少年因其他原因需要进行PLIF或TLIF，例如伴有或不伴有腰椎不稳的先天性严重狭窄需要广泛减压，或需要去除严重骨赘。在这种情况下，预期其病理生理学和结果与成年患者不同。
我们回顾性分析了23例年龄小于20岁时接受PLIF或TLIF手术患者的数据。在平均36.4个月的随访期内评估临床和影像学结果。分析腰椎椎间融合的适应证、融合成功率、并发症及视觉模拟评分（VAS）。
所有患者术后6个月的X线片显示融合。临床结果也令人满意，VAS评分从术前的7.7改善至术后6个月时的2.3。仅1例患者因相邻节段疾病再次手术。
对于患有严重骨赘、巨大中央型椎间盘破裂或严重椎体滑脱的青少年患者，腰椎椎间融合手术具有良好的手术效果，并发症较少。
