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单节段旁路固定治疗腰椎滑脱症:解剖学见解与技术要点

Single bypass fixation for the treatment of lumbar spondylolisthesis: Anatomical insights and technical note.

作者信息

Faraj Moneer K, Saad Mohammed Bani, Ismail Mustafa

机构信息

Department of Surgery, University of Baghdad, College of Medicine, Baghdad, Iraq.

Department of Surgery, Iraqi Medical Association, Baghdad, Iraq.

出版信息

Surg Neurol Int. 2024 Sep 20;15:338. doi: 10.25259/SNI_591_2024. eCollection 2024.

Abstract

BACKGROUND

Lumbar spondylolisthesis usually requires surgical management for the stabilization of the spine and to relieve patients of their symptoms. This study aims to provide anatomical insights and evaluate the efficacy of single bypass fixation in the surgical treatment of lumbar spondylolisthesis. This technique aims to stabilize the spine with minimal manipulation of the slipped vertebra, thereby reducing potential complications and improving clinical outcomes.

METHODS

This is a retrospective study carried out at a neurosurgical hospital in Baghdad, Iraq, including 35 cases of lumbar spondylolisthesis subjected to single bypass fixation treatment between December 2012 and December 2019. The procedure involves stabilizing the lumbar spine by fixing the vertebrae above and below the affected segment using pedicle screws and rods, guided by fluoroscopy to ensure accurate placement and avoid neurovascular injury. Laminectomy was performed as needed to decompress the spinal cord and nerve roots. Autograft or allograft bone was used to promote fusion around the stabilized segment. Pre- and postoperative clinical and radiological assessments were conducted. Pre- and postoperative clinical and radiological assessments were done.

RESULTS

There have been enormous gains in terms of pain relief, neurological status, and spinal stability, with the achievement of high fusion rates and low complication rates.

CONCLUSION

Single-level bypass fixation proves efficacy for lumbar stabilization in spondylolisthesis patients, with the best clinical result and less complication for patients.

摘要

背景

腰椎滑脱通常需要手术治疗以稳定脊柱并缓解患者症状。本研究旨在提供解剖学见解,并评估单节段旁路固定术在腰椎滑脱手术治疗中的疗效。该技术旨在通过对滑脱椎体进行最小程度的操作来稳定脊柱,从而减少潜在并发症并改善临床结果。

方法

这是一项在伊拉克巴格达一家神经外科医院进行的回顾性研究,纳入了2012年12月至2019年12月间接受单节段旁路固定治疗的35例腰椎滑脱患者。该手术包括在透视引导下使用椎弓根螺钉和棒固定受累节段上下的椎体以稳定腰椎,确保准确放置并避免神经血管损伤。根据需要进行椎板切除术以减压脊髓和神经根。使用自体骨或同种异体骨促进稳定节段周围的融合。进行了术前和术后的临床及影像学评估。

结果

在缓解疼痛、神经状态和脊柱稳定性方面取得了巨大进展,实现了高融合率和低并发症率。

结论

单节段旁路固定术被证明对腰椎滑脱患者的腰椎稳定有效,对患者具有最佳临床效果且并发症较少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850b/11450859/3507503334b8/SNI-15-338-g001.jpg

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