外伤性骨折的侧胸腰椎椎间融合术(创伤LLIF) -技术描述和科学证据总结。

IF 0.7 4区 医学 Q4 SURGERY
Stefan Motov, Benjamin Martens, Martin N Stienen
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引用次数: 0

摘要

累及前柱的胸腰椎A3和A4骨折比单独后路固定有更大的矫正损失和假体失败的风险。LLIF技术是在退行性脊柱手术中建立起来的,可以在特定的创伤病例中提供优势。我们描述了手术技术和我们自己的经验。一项回顾性单中心队列研究纳入61例神经功能完整的胸腰椎骨折(T10-L3)患者,采用围周手术(后路+ lliff)治疗12年。前路重建主要或次要通过腹膜后(腰椎)或经胸(胸)入路进行。主要终点是节段性矫正、融合、并发症和临床结果。节段Cobb角明显改善(术前14.6°,术后6.7°,终随访8.1°
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Lateral Thoracolumbar Interbody Fusion for Traumatic Fractures (Trauma LLIF) - Description of Technique and Summary of Scientific Evidence].

Thoracolumbar A3 and A4 fractures involving the anterior column are at greater risk of correction loss and implant failure than with stand-alone posterior fixation. The LLIF technique, established in degenerative spine surgery, may offer advantages in selected trauma cases.We describe the surgical technique and our own experience with it. A retrospective single centre cohort study included 61 neurologically intact patients with thoracolumbar fractures (T10-L3) treated over 12 years using circumferential surgery (posterior + LLIF). The anterior reconstruction was performed either primarily or secondarily via retroperitoneal (lumbar) or transthoracic (thoracic) approaches. Primary endpoints were segmental correction, fusion, complications, and clinical outcome.Segmental Cobb angle significantly improved (preoperative 14.6°, postoperative 6.7°, final follow-up 8.1°; p < 0.001). The fusion rate was 98.4%. The overall complication rate was moderate (18%), mostly related to the posterior approach. According to MacNab criteria, 95.1% of patients achieved a good or excellent outcome. No adjacent segment degeneration was observed.LLIF provides a reliable anterior reconstruction in unstable thoracolumbar fractures, with good correction maintenance, high fusion rates, and favourable clinical results. It may be a valuable addition to posterior instrumentation in selected trauma cases.

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来源期刊
CiteScore
1.00
自引率
14.30%
发文量
116
审稿时长
6-12 weeks
期刊介绍: Konzentriertes Fachwissen aus Forschung und Praxis Das Zentralblatt für Chirurgie – alle Neuigkeiten aus der Allgemeinen, Viszeral-, Thorax- und Gefäßchirurgie.
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