腰椎后外侧融合术在腰椎退变性疾患手术中应用的再认识

doi:10.6040/j.issn.1671-7554.0.2019.309

摘要/Abstract

摘要： 腰椎后外侧融合术是腰椎手术中常用的融合技术,因腰椎后外侧解剖结构的特点、横突间植骨后力学特点、骨床制备工具和内固定技术的限制,早期植骨融合率受到一定的影响。腰椎后外侧融合技术被后来开发的融合技术所替代。随着不同手术入路选择、手术技术提高、先进工具使用、植骨材料发展及内固定的合理应用,腰椎后外侧融合技术被重新应用于腰椎退变性疾患手术中并取得良好的植骨融合率。但腰椎后外侧融合技术在治疗腰椎不稳、椎体滑脱或多节段腰椎退变疾患中的生物力学特点和临床疗效,仍需要进一步研究。

关键词: 腰椎融合, 腰椎后外侧融合, 腰椎退变性疾患

Abstract: Lumbar posterolateral fusion(PLF)has been commonly used in lumbar surgery. In the previous years, due to the characteristics of posterolateral anatomy, mechanics of intertransverse fusion and deficiency of bone graft tools and internal fixation, the fusion rate was impaired and lumbar PLF was gradually replaced by other fusion techniques. 山东大学学报 (医学版)57卷5期 -郑燕平,等.腰椎后外侧融合术在腰椎退变性疾患手术中应用的再认识 \=-Currently, along with the emergence and development of various operative approaches, surgical skills, advanced tools, bone graft materials, and internal fixation techniques, PLF is reused in the treatment of lumbar degenerative diseases and has achieved satisfactory fusion ratio. However, more remains to be done to explore the biomechanical characteristics and clinical effects of lumbar PLF when it is used in the treatment of lumbar vertebral instability, lumbar spondylolisthesis and multi-segment lumbar degenerative diseases.

Key words: Lumbar vertebral fusion, Lumbar posterlateral fusion, Lumbar degenerative disease

中图分类号:

R681.5

郑燕平,周超. 腰椎后外侧融合术在腰椎退变性疾患手术中应用的再认识[J]. 山东大学学报 (医学版), 2019, 57(5): 18-22.

ZHENG Yanping, ZHOU Chao. Application of lumbar posterolateral fusion for lumbar degenerative diseases[J]. Journal of Shandong University (Health Sciences), 2019, 57(5): 18-22.

参考文献

[1] Hibbs RA. An operation for progressive spinal deformities: a preliminary report of three cases from the service of the orthopaedic hospital. 1911[J]. Clin Orthop Relat Res, 2007, 460: 17-20. doi:10.1097/BLO.0b013e3180686b30.
[2] Watkins MB. Posterolateral fusion of the lumbar and lumbosacral spine [J]. J Bone Joint Surg, 1953, 35(4): 1014-1018.
[3] Adkins EWO. Lumbo-sacral arthrodesis after laminectomy [J]. J Bone Joint Surg Br, 1955, 37-B(2): 208-223.
[4] Rombold C. Treatment of spondylolisthesis by posterolateral fusion, resection of the parsinterarticularis, and prompt mobilization of the patient. An end-result study of seventy-three patients [J]. J Bone Joint Surg Am, 1966, 48(7): 1282-1300.
[5] Watkins MB. Posterolateral bone grafting for fusion of the lumbar and lumbarsacral spine [J]. J Bone Joint Surg Am, 1959, 41(3): 388-396.
[6] Wiltse LL, Bateman JG, Hutchinson RH, et al. The paraspinal sacrospinalis-splitting approach to the lumbar spine [J]. J Bone Joint Surg Am, 1968, 50(5): 919-926.
[7] Zhou C, Tian YH, Zheng YP, et al. Mini-invasive transforaminal lumbar interbody fusion through wiltse approach to treating lumbar spondylolytic spondylolisthesis [J]. Orthopaedic Surgery, 2016, 8(1): 44-50.
[8] John A, Mc Culloch, Paul H, et al. Essentials of spinal microsuregery[M]. Philadelphia: Lippincott, 1998: 531.
[9] 王大伟, 韩士章, 张左伦. 腰椎后外侧融合术[J]. 中国矫形外科杂志, 2004, 12(5): 374-376.
[10] Burwell RG. The function of bone marrow in the incorporation of a bone graft [J]. Clin Orthop, 1985, 200: 125-141.
[11] Morris MT, Tarpada SP, Cho W. Bone graft materials for posterolateral fusion made simple: a systematic review [J]. Eur Spine J, 2018, 27(8): 1856-1867.
[12] Dimar JR, Glassman SD, Burkus JK, et al. Two-year fusion and clinical outcomes in 224 patients treated with a single-level instrumented posterolateral fusion with iliac crest bone graft [J]. Spine, 2009, 9(11): 880-885.
[13] Fischgrund JS, Mackay M, Herkowitz HN, et al. 1997 Volvo Award winner in clinical studies. Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective, randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation [J]. Spine J,1997, 22(24): 2807-2812.
[14] Kimura I, Shingu H, Murata M, et al. Lumbar posterolateral fusion alone or with transpedicular instrumentation in L4-L5 degenerative spondylolisthesis [J]. J Spin Disord, 2001, 14(4): 301-310.
[15] Epstein NE. A preliminary study of the efficacy of Beta Tricalcium Phosphate as a bone expander for instrumented posterolateral lumbar fusions [J]. J Spinal Disord Tech, 2006, 19(6): 424-429.
[16] Sengupta DK, Truumees E, Patel CK, et al. Outcome of local bone versus autogenous iliac crest bone graft in the instrumented posterolateral fusion of the lumbar spine[J]. Spine, 2006, 31(9):985-991.
[17] Odri GA, Hami A, Pomero V et al. Development of a preoperative procedure for concentrated bone marrow adjunction in postero-lateral lumbar fusion: radiological, biological and clinical assessment [J]. Eur Spine J, 2012, 21(12): 2665-2672.
[18] Jorgenson SS, Lowe TG, France J, et al. A prospective analysis of autograft versus allograft in posterolateral lumbar fusion in the same patient: A minimum of 1-year follow-up in 144 patients [J]. Spine, 1994, 19(18): 2048-2053.
[19] Hart R, Komzák M, Okál F, et al. Allograft alone versus allograft with bone marrow concentrate for the healing of the instrumented posterolateral lumbar fusion [J]. Spine, 2014, 14(7): 1318-1324.
[20] Kang J, An H, Hilibrand A, et al. Grafton and local bone have comparable outcomes to iliac crest bone in instrumented single-level lumbar fusions [J]. Spine, 2012, 37(12): 1083-1091.
[21] Acharya NK, Kumar RJ, Varma HK, et al. Hydroxyapatite-bioactive glass ceramic composite as standalone graft substitute for posterolateral fusion of lumbar spine: a prospective matched, and controlled study [J]. J Spine Disord Tech, 2008, 21(2): 106-111.
[22] Ploumis A, Albert TJ, Brown Z, et al. Healos graft carrier with bone marrow aspirate instead of allograft as adjunct to local autograft for posterolateral fusion in degenerative lumbar scoliosis: a minimum 2-year follow-up study [J]. J Neurosurg Spine, 2010, 13(2): 211-215.
[23] Gupta A, Kukkar N, Sharif K, et al. Bone graft substitutes for spine fusion: a brief review [J]. World J Orthop, 2015, 6(6): 449-456.
[24] Dimar JR, Glassman SD, Burkus JK, et al. Two-year fusion and clinical outcomes in 224 patients treated with a single-level instrumented posterolateral fusion with iliac crest bone graft [J]. Spine, 2009, 9(11): 880-885.
[25] Tajima N, Chosa E, Watanabe S. Posterolateral lumbar fusion [J]. J Orthop Sci, 2004, 9(3): 327-333.
[26] Nork SE, Hu SS, Workman KL, et al. Patient outcomes after decompression and instrumented posterior spinal fusion for degenerative spondylolisthesis [J]. Spine, 1999, 24(6): 561-569.
[27] Glassman SD, Carreon LY, Ghogawala Z, et al. Benefit of transforaminal lumbar interbody fusion vs posterolateral spinal fusion in lumbar spine disorders: a propensity-matched analysis from the national neurosurgical quality and outcomes database registry [J] Neurosurgery, 2016, 79(3): 397-405.
[28] Ha KY, Na KH, Shin JH, et al. Comparison of posterolateral fusion with and without additional posterior lumbar interbody fusion for degenerative lumbar spondylolisthesis [J]. J Spinal Disord Tech, 2008, 21(4): 229-234.
[29] Owens RK, Carreon LY, Djurasolvic M, et al. Relative benefit of TLIF versus PSF stratified by diagnostic indication [J]. J Spinal Disord Tech, 2014, 27(3): 144-147.
[30] Bozkurt G, Isikay I, Hanalioglu S. Radiological and clinical comparison of posterolateral fusion and transforaminal [J]. World Neurosurg, 2018, 116: e1060-e1065. doi: 10.1016/j.wneu.
[31] Madan S, Boeree NR. Outcome of posterior lumbar interbody fusion versus posterolateral fusion for spondylolytic spondylolisthesis [J]. Spine, 2002, 27(15): 1536-1542.
[32] Majid RF, Golnaz Y, Mehrnaz G, et al. Clinical outcomes of posterolateral fusion versus posterior lumbar interbody fusion in patients with lumbar spinal stenosis and degenerative instability [J]. Pain Physician, 2018, 21: 383-406.
[33] Chen CS, Cheng CK, Liu CL. A biomechanical comparison of posterolateral fusion and posterior fusion in the lumbar spine [J]. J Spinal Disord Tech, 2002, 15(1): 53-63.
[34] Brodsky AE, Kovalsky ES, Khail MA. Correlation of radiological assessment of lumbar spine fusion with surgical exploration [J]. Spine, 1991, 16(Suppl 6): 216-215.
[35] Lenke LG, Bridwell KH, Bullis D, et al. Result of insitufusion for ischimic spondylolisthesis [J]. J Spinal Disord, 1992, 5(4): 433-442.

相关文章 15

[1]	樊彦伟,严冬雪,招友. 富氢水对兔腰椎间盘退变的影响[J]. 山东大学学报（医学版）, 2017, 55(3): 38-42.
[2]	王庆石,陈允震,刘海春,武文亮,焦广俊,李晓峰,徐大霞. 髓核细胞分泌的炎症因子对后纵韧带成纤维细胞增殖与成骨能力的影响[J]. 山东大学学报（医学版）, 2016, 54(6): 22-26.
[3]	周超, 田永昊, 郑燕平, 刘新宇, 王虎虎. 经椎间孔腰椎椎体间融合术治疗单节段退变性腰椎滑脱的疗效分析[J]. 山东大学学报（医学版）, 2015, 53(12): 71-75.
[4]	王秉翔1，聂林1, 蒲华清2，张志勉2. Dynesys动态稳定系统与腰椎后路椎体间融合术术后疗效的Meta分析[J]. 山东大学学报(医学版), 2013, 51(9): 72-78.
[5]	宁斌1，龚维明1，李玲梅2，郭洁1，夏启杆1，宁红1，贾堂宏1. 微载体旋转立体培养对成人退变髓核细胞凋亡调控的研究[J]. 山东大学学报(医学版), 2012, 50(12): 98-.
[6]	刘杨，苗宇船. 滋补脾阴方药对大鼠脊髓损伤后脑源性神经营养因子表达的影响[J]. 山东大学学报(医学版), 2012, 50(10): 33-36.
[7]	李仁杰,陈海,罗远健,陆禹严. 单纯植骨与钛网填充植骨治疗椎体结核的疗效分析[J]. 山东大学学报(医学版), 2011, 49(6): 115-.
[8]	刘洋，贾堂宏，龚维明，宁斌，郭舒亚，宋宏亮，徐鹏，张涛，张来波 . 脊髓损伤后大鼠水钠代谢紊乱动物模型的建立[J]. 山东大学学报(医学版), 2009, 47(03): 53-55.
[9]	祁磊,李牧,李玉华,蔡中续,孙元亮. 峡部裂性腰椎滑脱的后路手术治疗[J]. 山东大学学报(医学版), 2008, 46(4): 438-440.
[10]	张喜善,蔡国栋,李建民,杨明峰 . 颈椎不稳黄韧带TGFβ1、BMP2表达的实验研究[J]. 山东大学学报(医学版), 2007, 45(12): 1253-1256.
[11]	汲长蛟,宫良泰,张寿涛 . 体重指数与腰椎间盘突出症发病的相关性临床研究[J]. 山东大学学报(医学版), 2007, 45(5): 520-523.
[12]	牛福文,聂林,侯勇,程雷. 人工颈椎间盘置换术治疗脊髓型颈椎病的临床评价[J]. 山东大学学报(医学版), 2007, 45(4): 430-431.
[13]	胡魁,刘培来,张元凯,丁明,周磊,李明. 急性脊髓损伤后自主神经异常反射与降钙素基因相关肽的相关性研究[J]. 山东大学学报(医学版), 2007, 45(4): 397-400.
[14]	王修文,谯勇,吴东进. bFGF和TNF-α在颈椎后纵韧带骨化中的作用[J]. 山东大学学报(医学版), 2007, 45(3): 279-282.
[15]	梁延琛，聂林，侯勇，程雷，杨彦才，曲高伟，耿伟. 人工颈椎间盘假体置换术治疗脊髓型颈椎病的临床效果[J]. 山东大学学报(医学版), 2008, 46(12): 1188-1191.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed