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一种获得良好局部前凸角的新型腰椎后路椎间融合技术：前路松解后路腰椎椎间融合术。

A novel technique for posterior lumbar interbody fusion to obtain a good local lordosis angle: anterior-release posterior lumbar interbody fusion.

作者信息

Inoue Daisuke, Matsumori Hiroaki, Shigematsu Hideki, Ueda Yurito, Morita Toshiya, Kawasaki Sachiko, Ikejiri Masaki, Tanaka Yasuhito

机构信息

Department of Orthopaedic Surgery, Kashiba Asahigaoka Hospital, Kashiba, Japan.

Department of Orthopaedic Surgery, Nara Medical University Hospital, Kashihara, Japan.

出版信息

Asian Spine J. 2024 Oct;18(5):706-711. doi: 10.31616/asj.2024.0131. Epub 2024 Aug 21.

DOI:10.31616/asj.2024.0131
PMID:39165060
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11538811/
Abstract

Herein, we describe a novel posterior lumbar interbody fusion (PLIF) technique with annulus fibrosus (AF) release and the use of expandable cages (called "anterior-release PLIF" [ARPLIF]). In this technique, posterior column osteotomy (PCO) and AF release provide excellent intervertebral mobility. AF release involves circumferentially peeling off the AF above or below the endplate between the fixed vertebrae under radiographic guidance without cutting the AF and anterior longitudinal ligament. Subsequently, high-angle variable-angle expandable cages are used to simultaneously expand both sides before inserting the percutaneous pedicle screws and correcting to achieve good local lumbar lordosis. PCO and AF release achieve excellent intervertebral mobility. Intervertebral mobility and simultaneous expansion of both cages disperse the force on the endplates, reducing cage subsidence, and the high-angle cages facilitate high intervertebral angle creation. The novel ARPLIF intervertebral manipulation technique can promote good local lumbar lordosis formation.

摘要

在此，我们描述一种新型的后路腰椎椎间融合术（PLIF），该技术包括纤维环（AF）松解及使用可扩张椎间融合器（称为“前路松解PLIF”[ARPLIF]）。在该技术中，后柱截骨术（PCO）和AF松解可提供出色的椎间活动度。AF松解是指在影像学引导下，在不切断AF和前纵韧带的情况下，沿终板上方或下方的固定椎体之间的纤维环进行环形剥离。随后，在插入经皮椎弓根螺钉并进行矫正之前，使用高角度可变角度可扩张椎间融合器同时扩张两侧，以实现良好的局部腰椎前凸。PCO和AF松解可实现出色的椎间活动度。椎间活动度和椎间融合器两侧的同时扩张可分散终板上的力，减少椎间融合器下沉，且高角度椎间融合器有助于形成较大的椎间角度。新型ARPLIF椎间操作技术可促进良好的局部腰椎前凸形成。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/550f/11538811/0a84cc477044/asj-2024-0131f8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/550f/11538811/15f6689a00a7/asj-2024-0131f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/550f/11538811/2565ddba3c27/asj-2024-0131f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/550f/11538811/ec5cb3b8f806/asj-2024-0131f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/550f/11538811/5317eeada9a6/asj-2024-0131f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/550f/11538811/e970f2868523/asj-2024-0131f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/550f/11538811/b2aa1ef33224/asj-2024-0131f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/550f/11538811/44dd3af9b79c/asj-2024-0131f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/550f/11538811/0a84cc477044/asj-2024-0131f8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/550f/11538811/15f6689a00a7/asj-2024-0131f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/550f/11538811/2565ddba3c27/asj-2024-0131f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/550f/11538811/ec5cb3b8f806/asj-2024-0131f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/550f/11538811/5317eeada9a6/asj-2024-0131f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/550f/11538811/e970f2868523/asj-2024-0131f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/550f/11538811/b2aa1ef33224/asj-2024-0131f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/550f/11538811/44dd3af9b79c/asj-2024-0131f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/550f/11538811/0a84cc477044/asj-2024-0131f8.jpg

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本文引用的文献

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在进行后路矫正融合手术后发现，腰椎外侧椎间融合术中意外发生前纵韧带破裂，导致局部脊柱前凸增加。
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