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微创经椎间孔腰椎椎间融合术的细微差别:技术综述

Nuances of the Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Technical Review.

作者信息

Vyas Daivik B, Park Brian J, Wang Michael Y

机构信息

Department of Neurosurgery, Miller School of Medicine, University of Miami, Miami, FL, USA.

Department of Neurosurgery, Miller School of Medicine, University of Miami, Miami, FL, USA

出版信息

Int J Spine Surg. 2025 Feb 24;19(S1):S28-S36. doi: 10.14444/8713.

Abstract

BACKGROUND

Transforaminal lumbar interbody fusion (TLIF) achieves anterior and posterior spinal arthrodesis through a single approach. Minimally invasive surgery (MIS) methods reduce surgical morbidity while achieving positive outcomes.

METHODS

The major MIS-TLIF techniques, from tubular to endoscopic approaches, are reviewed with a discussion on the incorporation of new technologies and a comparative review of their outcomes.

RESULTS

MIS-TLIF approaches span a spectrum of visualization methods, with technical nuances related to patient and surgeon-specific factors determining optimal fit. To date, the superiority of 1 technique has yet to be definitively determined. Existing techniques may be integrated in a personalized manner to optimize surgical utility.

CONCLUSIONS

Selection of an MIS-TLIF modality relies on a calculus between patient characteristics and surgeon faculty; proper selection can offer significant benefits to patients with spine disease.

CLINICAL RELEVANCE

Emerging technologies for MIS-TLIF comprise a major source of development and clinical translation, while the safe and effective use of these techniques promises greater patient benefit in the right populations.

摘要

背景

经椎间孔腰椎椎间融合术(TLIF)通过单一入路实现脊柱前后路融合。微创手术(MIS)方法在取得良好疗效的同时降低了手术并发症。

方法

回顾了从管状入路到内镜入路的主要MIS-TLIF技术,并讨论了新技术的纳入情况以及对其疗效的比较性综述。

结果

MIS-TLIF入路涵盖一系列可视化方法,技术细节与患者和外科医生的特定因素相关,这些因素决定了最佳匹配方式。迄今为止,尚未明确确定一种技术的优越性。现有技术可以以个性化方式整合,以优化手术效用。

结论

MIS-TLIF术式的选择依赖于患者特征与外科医生能力之间的权衡;正确的选择可为脊柱疾病患者带来显著益处。

临床意义

MIS-TLIF的新兴技术是发展和临床转化的主要来源,而这些技术的安全有效应用有望在合适的人群中为患者带来更大益处。

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