[微创手术治疗腰椎融合术后邻近节段疾病的进展]。

D S Liu, Y X Wang, Paerhati Rexiti
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引用次数: 0

摘要

邻近节段疾病(ASDis)是后腰椎融合术的常见并发症,通常需要手术治疗。在ASDis的治疗中,经皮脊柱内窥镜可用于不去除原有内固定的简单减压,也可在内镜下或结合其他入路固定和融合技术进行后固定和融合,具有手术创伤小、出血少、术后恢复快的优点。传统的轨迹螺钉技术是邻近节段退变的危险因素之一,因为它在手术中容易对邻近滑膜关节造成损伤。相比之下,皮质张力轨迹(CBT)螺钉置入技术不仅减少了螺钉置入过程中对关节关节的损伤,而且在治疗ASDis时保留了原有的内固定,显著减少了手术创伤。其次,借助三维打印导轨、CT导航和机器人等数字技术植入CBT螺钉,可以对ASDis患者进行更精确的“双重钉扎”,以完成相邻节段的融合,是符合临床融合指征的患者需要考虑的微创手术。本文综述了经皮脊柱内窥镜和CBT在ASDis手术治疗中的应用文献。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Progress in minimally invasive surgery for adjacent segment disease after lumbar fusion].

Adjacent segment disease (ASDis) is a common complication of posterior lumbar spine fusion and often requires surgical treatment. In the treatment of ASDis, percutaneous spinal endoscopy can be used for simple decompression without removal of the original internal fixation, or for posterior fixation and fusion under the scope or in combination with other access fixation and fusion techniques, with the advantages of less surgical trauma, less bleeding, and faster postoperative recovery. Traditional trajectory screw technique is one of the risk factors for adjacent segment degeneration because of its tendency to cause damage to the adjacent synovial joint during surgery. In contrast, the cortical tone trajectory (CBT) screw placement technique not only reduces the damage to the articular joint during the screw placement process, but also preserves the original internal fixation in the treatment of ASDis, which significantly reduces the surgical trauma. Secondly, the implantation of CBT screws with the aid of digital technologies such as three-dimentinal printed guides, CT navigation, and robotics allows for more precise "double nailing" of ASDis patients to complete the fusion of adjacent segments, and is a minimally invasive procedure to be considered for patients who meet the clinical indications for fusion. This article reviews the literature on the use of percutaneous spinal endoscopy and CBT in the surgical management of ASDis.

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