Niesche Marco, Juratli Tareq A, Sitoci Kerim-Hakan, Neidel Julia, Daubner Dirk, Schackert Gabriele, Leimert Mario
Department of Neurosurgery, University Hospital'Carl Gustav Carus', Technical University Dresden, Germany.
Department of Neurosurgery, University Hospital'Carl Gustav Carus', Technical University Dresden, Germany.
Clin Neurol Neurosurg. 2014 Sep;124:25-31. doi: 10.1016/j.clineuro.2014.06.020. Epub 2014 Jun 23.
To determine if minimally invasive transforaminal lumbar interbody fusion (TLIF) using the Medtronic Sextant system is a reliable surgical treatment option in patients with recurrent lumbar disc herniation, compared with the traditional open procedure.
Clinical and radiographic data were retrospectively collected from a total of 33 patients who underwent single level lumbar fusion between 2007 and 2010. 14 underwent minimally invasive TLIF using the Sextant system, and the other 19 patients underwent the open procedure. All patients suffered from at least first recurrent lumbar disc herniation, and additionally from disc degeneration associated with erosive chondrosis Modic grade I-II due to previous surgical, non-instrumental interventions.
Median operation time in the minimally invasive group was 140 min (95-190); average X-ray exposure time: 2.35 min (1.5-3.5); median postoperative resting time in hospital: 5 days (3-7). Postoperative pain relief and mobility improvement were documented with the visual analogue scale (6.9-3.0) and the Oswestry Disability Index (6.8-2.4). All patients benefited from surgery at follow up. These data were on many terms significantly superior compared with data of patients in the open surgery group.
Percutaneous minimally invasive TLIF technique with the Medtronic Sextant system is a gentle, tissue protecting and safe alternative procedure for lumbar fusion in patients with recurrent lumbar disc herniation and erosive chondrosis.
与传统开放手术相比，确定使用美敦力Sextant系统进行微创经椎间孔腰椎椎体间融合术（TLIF）在复发性腰椎间盘突出症患者中是否为可靠的手术治疗选择。
回顾性收集了2007年至2010年间接受单节段腰椎融合术的33例患者的临床和影像学资料。14例患者使用Sextant系统进行了微创TLIF，另外19例患者接受了开放手术。所有患者均至少患有首次复发性腰椎间盘突出症，并且由于先前的手术、非器械干预而患有与侵蚀性软骨病Modic I-II级相关的椎间盘退变。
微创组的中位手术时间为140分钟（95 - 190）；平均X线暴露时间：2.35分钟（1.5 - 3.5）；术后中位住院休息时间：5天（3 - 7）。通过视觉模拟量表（6.9 - 3.0）和Oswestry功能障碍指数（6.8 - 2.4）记录了术后疼痛缓解和活动能力改善情况。所有患者在随访时均从手术中获益。这些数据在许多方面明显优于开放手术组患者的数据。
使用美敦力Sextant系统的经皮微创TLIF技术是复发性腰椎间盘突出症和侵蚀性软骨病患者进行腰椎融合的一种温和、保护组织且安全的替代手术。
