倾向于跨体腰椎间体融合,用于退行性磁盘疾病
Daniel K Park1,2, Philip Zakko1, Matthew S Easthardt1
1Department of Orthopaedic Surgery, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan.
JBJS essential surgical techniques
|January 22, 2025
概括
倾向于穿越的腰部体融合 (PTP) 与传统的横向融合相比,提供了更多的好处,包括改善了角对齐和降低了受伤风险. 这种技术提供了与横向方法相似的结果,在患者定位和同时手术方面具有潜在的优势.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 最少侵入性脊柱手术是最少侵入性的.
- 整形外科手术 整形外科手术
背景情况:
- 倾向于跨腰椎间体融合 (PTP) 是一种不断发展的脊椎盘病理治疗技术.
- 这是一种侧侧腰间体融合 (LLIF) 的变化,在患者躺下时进行.
- 与传统的开放手术相比,PTP提供了诸如减少血液损失,更短的住院时间和更快的恢复等好处.
研究的目的:
- 描述PTP技术及其与传统横向方法相比的优势.
- 为了突出倾向性定位的好处,腰部内体融合.
- 为了将PTP与腰椎间盘病理的其他外科选择进行比较.
主要方法:
- 在全身麻醉下进行PTP,并进行神经监测 (SSEP和EMG).
- 该程序涉及倾斜的定位,光学指导和通过腹肌进行粗的剖析.
- 关键步骤包括磁盘空间的准备,体间的放置和伤口的关闭.
主要成果:
- PTP允许更好的后部收缩的psoas肌肉和腰椎,创造一个更安全的手术走廊.
- 倾斜的位置有助于改善斜腿的对齐和潜在的更好的脊骨平衡.
- 与侧向方法相比,PTP可能会最大限度地降低肠/膀损伤和神经不良症的风险.
- 同时的后部解压和融合是可能的,没有重新定位.
结论:
- 与侧向方法相比,PTP提供了潜在的优势,包括提高安全性和效率.
- 这种技术可能会导致更好的临床结果,因为增强了腰对齐.
- PTP提供了与LLIF相似的结果,同时可能减少运营风险,并使联合程序成为可能.
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