Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore.
Spine Division, Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore.
Medicina (Kaunas). 2024 Feb 23;60(3):378. doi: 10.3390/medicina60030378.
Lumbar interbody fusion procedures have seen a significant evolution over the years, with various approaches being developed to address spinal pathologies and instability, including posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), anterior lumbar interbody fusion (ALIF), and lateral lumbar interbody fusion (LLIF). LLIF, a pivotal technique in the field, initially emerged as extreme/direct lateral interbody fusion (XLIF/DLIF) before the development of oblique lumbar interbody fusion (OLIF). To ensure comprehensive circumferential stability, LLIF procedures are often combined with posterior stabilization (PS) using pedicle screws. However, achieving this required repositioning of the patient during the surgical procedure. The advent of single-position surgery (SPS) has revolutionized the procedure by eliminating the need for patient repositioning. With SPS, LLIF along with PS can be performed either in the lateral or prone position, resulting in significantly reduced operative time. Ongoing research endeavors are dedicated to further enhancing LLIF procedures making them even safer and easier. Notably, the integration of robotic technology into SPS has emerged as a game-changer, simplifying surgical processes and positioning itself as a vital asset for the future of spinal fusion surgery. This literature review aims to provide a succinct summary of the evolutionary trajectory of lumbar interbody fusion techniques, with a specific emphasis on its recent advancements.
腰椎体间融合术近年来经历了显著的发展,各种方法被开发出来以解决脊柱病变和不稳定性,包括后路腰椎体间融合术(PLIF)、经椎间孔腰椎体间融合术(TLIF)、前路腰椎体间融合术(ALIF)和侧方腰椎体间融合术(LLIF)。LLIF 是该领域的一项关键技术,最初是在开发斜侧方腰椎体间融合术(OLIF)之前出现的极外侧/直接侧方腰椎体间融合术(XLIF/DLIF)。为了确保全面的环周稳定性,LLIF 手术通常与后路稳定(PS)结合使用椎弓根螺钉。然而,为了实现这一目标,需要在手术过程中重新定位患者。单体位手术(SPS)的出现彻底改变了这一过程,无需患者重新定位。采用 SPS,LLIF 联合 PS 可以在侧卧位或俯卧位进行,显著缩短了手术时间。目前的研究工作致力于进一步增强 LLIF 手术,使其更加安全和简便。值得注意的是,机器人技术在 SPS 中的集成已经成为一个变革性的进展,简化了手术流程,将自身定位为脊柱融合手术未来的重要资产。本文旨在简要综述腰椎体间融合技术的演进轨迹,并特别强调其近期进展。