Porrino Jack, Rao Aditya, Moran Jay, Wang Annie, Grauer Jonathan, Haims Andrew, Kani Kimia
Yale Radiology and Biomedical Imaging, Yale University, 330 Cedar Street, New Haven, CT, 06520, USA.
Yale School of Medicine, Yale University, 333 Cedar Street, New Haven, CT, 06510, USA.
Skeletal Radiol. 2021 Nov;50(11):2169-2184. doi: 10.1007/s00256-021-03840-6. Epub 2021 Jun 15.
Spinal fusion is performed to eliminate motion at a degenerated or unstable segment. However, this is associated with loss of motion at the fused levels and increased stress on adjacent levels. Motion-preserving implants have been designed in effort to mitigate the limitations of fusion. This review will focus on posterior spinal motion-preserving technologies. In the cervical spine, laminoplasty is a posterior motion-preserving procedure used in the management of myelopathy/cord compression. In the lumbar spine, motion-sparing systems include interspinous process devices (also referred to as interspinous process spacers or distraction devices), posterior dynamic stabilization devices (also referred to as pedicle screw/rod fixation-based systems), and posterior element replacement systems (also referred to as total facet replacement devices). Knowledge of the intended physiologic purpose, hardware utilized, and complications is important in the assessment of imaging in those who have undergone posterior motion preservation procedures.
脊柱融合术用于消除退变或不稳定节段的活动。然而,这会导致融合节段活动丧失,并增加相邻节段的应力。为减轻融合的局限性,人们设计了保留运动功能的植入物。本综述将聚焦于脊柱后路保留运动功能技术。在颈椎,椎板成形术是用于治疗脊髓病/脊髓受压的后路保留运动功能手术。在腰椎,保留运动功能的系统包括棘突间装置(也称为棘突间间隔器或撑开装置)、后路动态稳定装置(也称为基于椎弓根螺钉/棒固定的系统)以及后路结构置换系统(也称为全关节突置换装置)。了解预期的生理目的、所使用的硬件以及并发症,对于评估接受过后路保留运动功能手术患者的影像学检查很重要。