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退变性腰椎滑脱的腰椎椎间融合术:技术、适应证及疗效综述

Lumbar Interbody Fusions for Degenerative Spondylolisthesis: Review of Techniques, Indications, and Outcomes.

作者信息

Spiker William Ryan, Goz Vadim, Brodke Darrel S

机构信息

University of Utah, Salt Lake City, UT, USA.

出版信息

Global Spine J. 2019 Feb;9(1):77-84. doi: 10.1177/2192568217712494. Epub 2018 May 23.

Abstract

STUDY DESIGN

Broad narrative review.

OBJECTIVES

To review and summarize the current literature on the outcomes, techniques, and indications of lumbar interbody fusion in degenerative spondylolisthesis.

METHODS

A thorough review of peer-reviewed literature was performed on the outcomes, techniques, and indications of lumbar interbody fusions in degenerative spondylolisthesis.

RESULTS

A number of studies have found similar results between interbody fusions and posterolateral fusion in the setting of degenerative spondylolisthesis. There is some evidence that suggests that interbody fusion may be a useful adjunct in the setting of unstable degenerative spondylolisthesis. The number of options for interbody fusions has quickly expanded. Initially, interbody fusions were accomplished via an anterior approach. Posterior and transforaminal interbody fusions are 2 options that accomplish an interbody fusion without the morbidity of an anterior approach. Over the past decade, minimally invasive options including extreme lateral, oblique, and minimally invasive transforaminal interbody fusions have gained popularity.

CONCLUSIONS

Lumbar interbody fusion can be a useful tool in the setting of unstable degenerative spondylolisthesis. A number of technique options, both open and minimally invasive, are available to accomplish an interbody fusion. The literature to this date does not support a clear benefit of one technique over others in the setting of degenerative spondylolisthesis.

摘要

研究设计

广泛的叙述性综述。

目的

回顾并总结目前关于退行性腰椎滑脱症腰椎椎间融合术的疗效、技术及适应证的文献。

方法

对同行评审的关于退行性腰椎滑脱症腰椎椎间融合术的疗效、技术及适应证的文献进行全面回顾。

结果

多项研究发现,在退行性腰椎滑脱症的情况下,椎间融合术与后外侧融合术的结果相似。有证据表明,在不稳定的退行性腰椎滑脱症中,椎间融合术可能是一种有用的辅助治疗方法。椎间融合术的选择数量迅速增加。最初,椎间融合术是通过前路完成的。后路和经椎间孔椎间融合术是两种无需前路手术并发症即可完成椎间融合的选择。在过去十年中,包括极外侧、斜行和微创经椎间孔椎间融合术在内的微创选择越来越受欢迎。

结论

在不稳定的退行性腰椎滑脱症中,腰椎椎间融合术可能是一种有用的治疗手段。有多种开放和微创技术可供选择来完成椎间融合术。迄今为止的文献并不支持在退行性腰椎滑脱症中一种技术比其他技术有明显优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc8c/6362558/5ba08d8a1a58/10.1177_2192568217712494-fig1.jpg

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