微创技术在腰椎固接定、融合术中的临床应用.pdfVIP

· 358 · 现代生物医学进展 VCrWW．biomed．net．cn ProgressinModernBiomedicine 2009 Vo1．9 No．2 微创技术在腰椎固定、融合术中的临床应用 刘 涛△ 周 跃 (第三军医大学新桥医院骨科 重庆400037) 摘要：近几年来，随着脊柱基础研究的发展以及各种新理论 、新方法、新技术相继出现，微创技术在临床中治疗各种腰椎疾患取得 了很大进步。脊柱微创外科，具有创伤小、出血少、术后疼痛轻、恢复快等优点，受到腰椎疾病患者的欢迎。目前用于腰椎椎间融合 的微创手术方法有前路腰椎椎体间融合术、后路腰椎椎体间融合术、经椎间孔腰椎椎体间融合术、极外侧椎体间融合术、轴向椎 体间融合术以及多种微创技术联合应用。不同微创技术各有其优缺点，具有不同手术适应征，在临床应用中需要根据腰椎疾患的 具体特征，选用合适的腰椎微创手术，以达到最佳临床效果。本文从腰椎微创手术入路改进、手术器械的创新以及在临床应用的 效果方面作一综述。 关键词：微创 ；腰椎融合；腰椎 中图分类号：R681 文献标识码：A 文章编号2009)02—358—04 TheClinicalApplicationofMinimallyInvasiveTechnique forLumbarInterbodyFusion LIUTao△．ZHOUYue (DepartmentofOrthopedics,XinqiaoHospital,ThirdMilitaryMedicineUniversity，400037,China) ABSTRACT：W iththeprogressofbasicresearchinspineandtheoccurrenceofnew theoriesandtechniquesinrecentyears，mini- mallyinvasivetechniquesadvancedrgeatlyforthemanagementofdiseasesoflumbarinclinic．Minimallyinvasivetechniquesinspine hadhtemeritsoflesstrauma，lessblood，lesspainandshortrecoveryinpostoperative，patientswithlumbardisorderswouldrather chooseminimallyinvasivesurgerythantraditionalopenapproaches．Recently，minimallyinvasivesurgeriesinspineincludeminimally invasiveanteriorlumbarinter—bodyfusion(mini—ALIF)，minimallyinvasiveexrtemelateralinter—bodyufsion(mini—XHF)，minimallyni— vasiveaxiallumbarinter—bodyufsion(Axia—LIF)，minimallyinvasivertansforaminallumbarinter-bodyufsion(mini-TLIF)，minimallyin— vasiveposteriorlumbarinter-bodyfusion(mini—PLIF)andpercutaneouspediclescrewfixation．Inordertoobtainbettereffectatpostoper- ation，minimallyinvasivesurgery shouldbeelectedaccordingtospecificdiseasefeatures．Thistextmainlyreviewedtheimprovedap— proachofminimallyinvasivemethods，hteadvanceininstrumentandtheircliniceffects． Keywords：Minimallyinvasive；Lumbarinter—bodyufsion；Lumbarspine ChineseLibrar