Lee Woo-Myung, You Ki-Han, Kang Min-Seok, Kim Jun-Hyun, Park Hyun-Jin
Department of Orthopaedic Surgery, Spine Center, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Department of Orthopaedic Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
Asian Spine J. 2023 Apr;17(2):392-400. doi: 10.31616/asj.2022.0227. Epub 2023 Jan 31.
Oblique lumbar interbody fusion is a minimally invasive procedure for treating degenerative lumbar disease. Its advantages include correcting coronal and sagittal spinal alignment and indirect neural decompression. However, achieving a successful outcome is limited in some patients who need direct decompression for central canal lesions including hard stenotic lesions (endplate or facet articular osteophytes and ossification of posterior longitudinal ligaments) and sequestration of the disk. Biportal endoscopic spinal surgery is a minimally invasive technique, which directly decompresses the lesion. By taking advantage of two procedures, in a longlevel lumbar lesion, alignment correction and direct decompression can be both achieved. Herein, the authors introduce multilevel lumbar fusion through oblique lumbar interbody fusion and selective direct decompression through biportal endoscopic spinal surgery and discuss the surgical indications, surgical pitfalls, and recommendations for application. Consequently, it is regarded as a minimally invasive interbody fusion method for patients with multilevel lumbar degenerative degeneration.
斜外侧腰椎椎间融合术是一种治疗退行性腰椎疾病的微创手术。其优点包括纠正脊柱的冠状面和矢状面排列以及间接神经减压。然而，对于一些需要对中央管病变进行直接减压的患者，包括硬性狭窄病变（终板或小关节突骨赘以及后纵韧带骨化）和椎间盘游离，成功获得理想结果存在一定限制。双门内镜脊柱手术是一种微创手术技术，可直接对病变进行减压。通过结合这两种手术，在长节段腰椎病变中，可同时实现排列矫正和直接减压。在此，作者介绍通过斜外侧腰椎椎间融合术进行多节段腰椎融合以及通过双门内镜脊柱手术进行选择性直接减压，并讨论手术适应证、手术陷阱及应用建议。因此，它被视为治疗多节段腰椎退变患者的一种微创椎间融合方法。
