Kim Young-Hoon, Ha Kee-Yong, Kim Youn-Soo, Kim Ki-Won, Rhyu Kee-Won, Park Jong-Beom, Shin Jae-Hyuk, Kim Young-Yul, Lee Jun-Seok, Park Hyung-Youl, Ko Jaeryong, Kim Sang-Il
Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
Asian Spine J. 2022 Dec;16(6):1022-1033. doi: 10.31616/asj.2022.0435. Epub 2022 Dec 27.
Lumbar interbody fusion (LIF) is an excellent treatment option for a number of lumbar diseases. LIF can be performed through posterior, transforaminal, anterior, and lateral or oblique approaches. Each technique has its own pearls and pitfalls. Through LIF, segmental stabilization, neural decompression, and deformity correction can be achieved. Minimally invasive surgery has recently gained popularity and each LIF procedure can be performed using minimally invasive techniques to reduce surgery-related complications and improve early postoperative recovery. Despite advances in surgical technology, surgery-related complications after LIF, such as pseudoarthrosis, have not yet been overcome. Although autogenous iliac crest bone graft is the gold standard for spinal fusion, other bone substitutes are available to enhance fusion rate and reduce complications associated with bone harvest. This article reviews the surgical procedures and characteristics of each LIF and the osteobiologics utilized in LIF based on the available evidence.
腰椎椎间融合术(LIF)是多种腰椎疾病的一种极佳治疗选择。LIF可通过后路、经椎间孔、前路以及外侧或斜入路进行。每种技术都有其优点和缺点。通过LIF,可以实现节段性稳定、神经减压和畸形矫正。近年来,微创手术越来越受欢迎,每种LIF手术都可以采用微创技术进行,以减少手术相关并发症并促进术后早期恢复。尽管手术技术有所进步,但LIF术后的手术相关并发症,如假关节形成,尚未得到克服。虽然自体髂嵴骨移植是脊柱融合的金标准,但也有其他骨替代物可用于提高融合率并减少与取骨相关的并发症。本文根据现有证据综述了每种LIF的手术操作、特点以及LIF中使用的骨生物制剂。