腰椎间融合技术和比.ppt

《腰椎间融合技术和比.ppt》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、Lumbarinterbodyfusion:TechniquesandcomparisonIntroductionLumbarinterbodyfusion(LIF)：placementofanimplant(cage,spacerorstructuralgraft)withintheintervertebralspaceafterdiscectomyandendplatepreparation.FivemainapproachesInterbodyfusion：lowerratesofpostoperativecomplication

2、sandpseudoarthrosisTechniquereviewPLIFOneoftheoriginalapproachesInitialdescriptionofthePLIFtechniquebyBriggsandMilliganin1944PLIFPLIFTechniquereviewTechniquereviewTechniquereviewTLIFOpeningtheneuralforamenononesideonly.HarmsandRolingerreportedin1982Direct,unilateralacces

3、stotheintervertebralforaminalspacewhilstreducingdirectdissectionandduraltears.TLIFTLIFPreservesligamentousstructureswhichareinstrumentaltorestoringbiomechanicalstabilityofthesegmentandadjacentstructuresAsingleunilateralincisionisabletoprovidebilateralanteriorcolumnsuppor

4、tTechniquereviewALIFAnterioraccesscorridorsforlumbarfusionhavebeenusedanddevelopedsincetheywereintroducedbyCarpenterin1932.Theanteriorretroperitonealapproachtotheventralsurfaceoftheexposeddisc,allowingcomprehensivediscectomyanddirectimplantinsertion.SuitableforlevelsL4/L

5、5andL5/S1ALIFALIFDisadvantagesRetrogradeejaculationvisceralandvascularinjuryTechniquereviewLLIFDescribedbyOzguretal.in2006SuitableforT12toL5.ThistechniqueisnotsuitablefortheL5/S1level.NeuromonitoringisessentialSuitableforalldegenerativeindications.Especiallyforsagittalan

6、dcoronaldeformitycorrection,lumbardegenerativescoliosiswithlaterolisthesis.Notbesuitableforseverecentralcanalstenosis,bonylateralrecessstenosisandhigh-gradespondylolisthesisNotbesuitableforpriorretroperitonealsurgeryorwithretroperitonealabscess,aswellaspatientswithabnorm

7、alvascularanatomy.LLIFAdvantage:MISmuscle-splittingapproachthatcanbeperformedwithrapidpostoperativemobilization.Aggressivedeformitycorrectioncanbeachievedwithhighfusionratesandcomprehensivediscspaceclearance.Disadvantages:Potentialrisksoflumbarplexus,psoasmuscleandboweli

8、njury,particularlyattheL4/5level.Vascularinjury,ifitoccurs,maybedifficulttocontrol.TechniquereviewOLIFF