Epworth Hospital, Richmond, Melbourne, VIC, Australia.
J Clin Neurosci. 2013 Dec;20(12):1762-6. doi: 10.1016/j.jocn.2013.02.018. Epub 2013 Aug 19.
Painful L5/S1 pseudoarthrosis has been previously managed with posterior excision and/or lumbar fusion. To our knowledge, the anterior approach for L5/S1 pseudoarthrectomy in the treatment of Bertolotti's syndrome has not been described. We present two patients with severe symptomatic L5/S1 pseudoarthroses that were successfully excised via an anterior retroperitoneal approach with 2 year clinical and radiological follow-up. The literature regarding surgical treatments for Bertolotti's syndrome is reviewed. The technique for an anterior retroperitoneal approach is described. This approach has been safe and effective in providing long term symptomatic relief to our two patients. Further studies comparing the outcomes of anterior versus posterior pseudoarthrectomy will guide the management of this condition.
先前，对于 L5/S1 假关节疼痛的治疗方法是后路切除和/或腰椎融合。据我们所知，在治疗 Bertolotti 综合征时，前路 L5/S1 假关节切除术尚未被描述。我们报告了两例严重症状性 L5/S1 假关节患者，他们通过前路腹膜后入路成功切除，临床和影像学随访 2 年。回顾了关于 Bertolotti 综合征手术治疗的文献。描述了前路腹膜后入路的技术。该方法对我们的两例患者安全有效，可长期缓解症状。进一步比较前路与后路假关节切除术结果的研究将指导该疾病的治疗。
