Branch C L, Branch C L
Surg Neurol. 1987 May;27(5):449-54. doi: 10.1016/0090-3019(87)90252-7.
The technique of posterior lumbar interbody fusion reported here consists of the following steps: The confluence of the spinous process and lamina removed en bloc during the exposure is contoured into three keystone plugs; the anterior third of the disc space is packed with bone fragments; the keystone plugs are tapped in posterior to the bone fragments and locked into place; and excess bone fragments are laid over the facets bilaterally and over the transverse processes if necessary to fuse the facet joints and create a posterior fusion. This fusion technique precludes the need for banked bone or for the harvest of autogenous iliac bone, and provides posterior stability with the facet fusion despite the removal of the posterior elements. This technique has been used in 172 patients, with excellent or good results in 129 patients (75%); included in that number were 82 patients expecting compensation and 25 patients with failed-back syndrome.
暴露过程中整块切除的棘突和椎板融合处被加工成三个关键骨栓；椎间盘间隙的前三分之一用骨碎片填充；将关键骨栓敲入骨碎片后方并锁定到位；如有必要，将多余的骨碎片双侧放置在小关节上以及横突上，以融合小关节并形成后外侧融合。这种融合技术无需使用储存骨或取自体髂骨，并且尽管切除了后部结构，但通过小关节融合提供了后外侧稳定性。该技术已应用于172例患者，其中129例（75%）效果优良；这其中包括82例期望获得赔偿的患者和25例腰椎手术失败综合征患者。
