Crock H V
Clin Orthop Relat Res. 1982 May(165):157-63.
A technique using dowel cutting instruments for anterior lumbar interbody fusion operations is recommended for the treatment of other failed spinal operations; certain disc lesions; in the management of selected cases of spondylolisthesis; certain spinal infections; following some vertebral fractures; correction of selected spinal deformities and in the treatment of rare miscellaneous cases, e.g., vertebral body tumors and nucleus pulposus calcification. Extra peritoneal approaches to the lumbar vertebral column are recommended. Dowel cavities are cut to predetermined depths with specially designed cutters of appropriate size. The greater bulk of disc tissues and vertebral end plate cartilages are then removed using ring curettes and pituitary rongeurs. Autogenous grafts are cut from the iliac crest using a cutter one size larger than that used to prepare the intervertebral dowel cavities. With the depths of the dowel cavities having been checked with a depth gauge, the grafts are duly impacted after careful retraction of all adjacent structures away from the cavities.
对于其他脊柱手术失败的情况、某些椎间盘病变、特定病例的腰椎滑脱管理、某些脊柱感染、部分椎体骨折后、选定脊柱畸形的矫正以及罕见的杂症（如椎体肿瘤和髓核钙化）的治疗，推荐一种使用销钉切割器械进行前路腰椎椎间融合手术的技术。建议采用经腹膜外途径进入腰椎柱。使用尺寸合适的特制切割器将销钉腔切割至预定深度。然后用环形刮匙和垂体咬骨钳去除大部分椎间盘组织和椎体终板软骨。使用比制备椎间销钉腔所用切割器大一号的切割器从髂嵴切取自体移植物。用深度计检查销钉腔的深度后，在小心地将所有相邻结构从腔中牵开后，将移植物适当地嵌入。
