Kwon Brian, Kim David Hanwuk
From Tufts University School of Medicine (Dr. Kwon) and the New England Baptist Hospital (Dr. Kwon and Dr. Kim), Boston, MA.
J Am Acad Orthop Surg. 2016 Feb;24(2):96-105. doi: 10.5435/JAAOS-D-14-00208.
Lateral lumbar interbody fusion is a minimally invasive spinal fusion technique that uses the retroperitoneal approach to the anterior spinal column. Mechanical and technical results of the technique compare favorably with those of anterior lumbar interbody fusion in regard to large graft placement, graft volumes, and early initial stability. Lateral lumbar interbody fusion uses the transpsoas approach and traverses near the lumbar plexus. It is not, however, without its unique complications. Groin pain or numbness is well tolerated and often temporary; however, quadriceps palsy can be long-lasting and debilitating. Rarer but serious complications include vascular and visceral injury. Lateral lumbar interbody fusion has been used successfully to treat common degenerative spinal conditions such as spinal instability, stenosis, scoliosis, and degenerative disk disease. While understanding of the lumbar plexus and the technical challenges of the procedure improves, lateral lumbar interbody fusion will continue to provide safe and successful clinical outcomes with less morbidity than traditional procedures.
腰椎侧方椎间融合术是一种微创脊柱融合技术,采用经腹膜后途径进入脊柱前路。该技术在大移植物放置、移植物体积和早期初始稳定性方面的力学和技术效果与腰椎前路椎间融合术相比具有优势。腰椎侧方椎间融合术采用经腰大肌途径,靠近腰丛走行。然而,它并非没有独特的并发症。腹股沟疼痛或麻木通常能较好耐受且多为暂时性;然而,股四头肌麻痹可能持续时间长且使人衰弱。更罕见但严重的并发症包括血管和内脏损伤。腰椎侧方椎间融合术已成功用于治疗常见的退行性脊柱疾病,如脊柱不稳、椎管狭窄、脊柱侧弯和椎间盘退变疾病。随着对腰丛的了解以及该手术技术挑战的改善,腰椎侧方椎间融合术将继续提供安全且成功的临床结果,其发病率低于传统手术。