Bae Junseok, Kim Shin-Jae, Lee Sang-Ho, Bae Youngsik, Jeon Sang Hyeop
Department of Neurosurgery, Chungdam Wooridul Spine Hospital, Seoul, Korea.
Department of General Surgery, Chungdam Wooridul Spine Hospital, Seoul, Korea.
Neurospine. 2021 Jun;18(2):399-405. doi: 10.14245/ns.2040640.320. Epub 2021 Jun 30.
Anterior lumbar interbody fusion (ALIF) has advantages over posterior lumbar interbody fusion or transforaminal lumbar interbody fusion techniques in that it minimizes damage to the anatomical structure of the posterior spinal segment and enables indirect decompression of the foramen by insertion of a tall cage. However, the predominant abdominal scar tissue reduces patients' satisfaction after ALIF. Herein, we describe the technique of transumbilical lumbar interbody fusion (TULIF) and its preliminary results in a case series.
A retrospective review of 154 consecutive patients who underwent TULIF between the L2-3 and L4-5 levels was performed. After preoperatively selecting patients by evaluating the location of the umbilicus and vessel anatomy, a vertical skin incision was made on the umbilicus to minimize the abdominal scar tissue.
There were 120 single-level (110 L4-5 and 10 L3-4), 31 two-level, and 3 three-level surgeries. All patients were very satisfied with their postoperative abdominal scars, which were noticeably faint compared to those after conventional ALIF.
TULIF is a feasible, minimally invasive surgical option that can achieve both the treatment of degenerative spinal disease and satisfactory cosmesis. Although it is technically demanding, patients obtain sufficient benefits.
腰椎前路椎间融合术（ALIF）相较于腰椎后路椎间融合术或经椎间孔腰椎椎间融合术具有优势，因为它能将对脊柱后段解剖结构的损伤降至最低，并通过植入高椎间融合器实现椎间孔的间接减压。然而，主要的腹部瘢痕组织会降低患者接受ALIF后的满意度。在此，我们描述经脐腰椎椎间融合术（TULIF）技术及其在一系列病例中的初步结果。
对154例连续接受L2 - 3至L4 - 5节段TULIF手术的患者进行回顾性研究。术前通过评估脐部位置和血管解剖结构选择患者后，在脐部做垂直皮肤切口以尽量减少腹部瘢痕组织。
有120例单节段手术（110例L4 - 5和10例L3 - 4），31例双节段手术和3例三节段手术。所有患者对术后腹部瘢痕都非常满意，与传统ALIF术后的瘢痕相比明显更淡。
TULIF是一种可行的微创手术选择，既能治疗退行性脊柱疾病，又能实现令人满意的美容效果。尽管该技术要求较高，但患者能获得足够的益处。
