Shibao Yosuke, Koda Masao, Abe Tetsuya, Mataki Kentaro, Miura Kousei, Noguchi Hiroshi, Takahashi Hiroshi, Funayama Toru, Yamazaki Masashi
Department of Orthopeadic Surgery, Faculty of Medicine, University of Tsukuba, Japan.
J Rural Med. 2021 Apr;16(2):111-114. doi: 10.2185/jrm.2020-057. Epub 2021 Apr 1.
To report a case of anterior longitudinal ligament (ALL) injury that was not noticeable during lateral lumbar interbody fusion and was disclosed after posterior corrective fusion surgery. After performing lateral lumbar interbody fusion followed by posterior corrective fusion surgery, we observed an anterior longitudinal ligament rupture that required additional surgery. Postoperative pain in the left lower limb and muscle weakness due to nerve traction appeared, but this was improved by stabilization between the vertebral bodies. Unidentified anterior longitudinal ligament rupture can result in unexpected local lordosis during posterior surgery, possibly related to lower extremity palsy. Therefore, checking for possible rupture during and after anterior surgery is important. If the ALL damage is disclosed before posterior surgery, the proper surgical strategy for the posterior surgery must be considered.
报告一例在腰椎侧方椎间融合术中未被发现、而在后方矫正融合术后才被发现的前纵韧带（ALL）损伤病例。在进行腰椎侧方椎间融合术并随后进行后方矫正融合术后，我们观察到前纵韧带破裂，这需要额外的手术。术后出现了左下肢疼痛和因神经牵拉导致的肌肉无力，但通过椎体间固定得到了改善。未被识别的前纵韧带破裂可导致后方手术期间意外的局部脊柱前凸，可能与下肢麻痹有关。因此，在前路手术期间及术后检查是否可能破裂很重要。如果在后方手术前发现前纵韧带损伤，必须考虑后方手术的适当手术策略。
