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1、1After transforaminal lumbar interbody fusion for lumbar degenerative instability of the clinical analysisAuthor: Wang Shuhai pay Guoquan Jifu Li Zhao Yanjun Wang Hu Gang Shi Jiao Yan Guofei Abstract Objective To evaluate the transforaminal lumbar fusion (TLIF lumbar degenerative instability of the
2、clinical efficacy and the advantages and disadvantages. Methods A retrospective analysis from January 2005 to October 2009 and was admitted to more than 1.5 years follow-up is not degenerative stability of 47 patients, all patients underwent combined posterior TLIF PLIF surgery, including 28 males a
3、nd 19 females, aged 45-69 years, mean 58.3 years, duration of 2 months -15 years, segmental instability, single segment of 33 cases, L4/L5/S1 double segment 9 cases, L2/L3/L4/L5, L3/L4/L5/S1 three segments in 2 cases, L1/L2/L3/L4/L5 four segments 1 cases. to have the spinal canal and nerve root cana
4、l stenosis of the line segment PLIF surgery, spinal stenosis of the segment is not retained on the spine, interspinous ligament and the lamina of the 2integrity of the line TLIF surgery, this group of patients in clinical efficacy of interbody fusion rates and correction of degenerative scoliosis ev
5、aluation results all 47 patients were followed up for 1-4 years, an average of 18 months in accordance with 29 points JOA low back pain were assessed standards (including symptoms, signs daily life such as the direction of movement and bladder function assessment of clinical efficacy, the mean preop
6、erative (11.7 + -6.5 assigned to the last follow-up (mean 22.7 + -11.6 points, including excellent in 32 cases, good in 13 cases, 2 cases, good rate of 95.7% of the conclusions in the treatment of degenerative lumbar instability, lumbar fusion after transforaminal approach for clinical efficacy, int
7、erbody fusion rate, is a worthy approach. Keywords: foraminal interbody fusion approach for clinical studies of degenerative lumbar instability Degenerative lumbar spine disease is a common disease in the elderly, associated with disc degeneration (prominent and spinal stenosis, a serious impact on
8、patient quality of life, increasingly in recent years, increasing aging population trend, so that the disease 3has increased every year. Its characteristics are: standing and walking and leg pain caused by back pain, lumbar hyperextension such symptoms. 1 Such patients are associated with lumbar ins
9、tability, posterior decompression alone often can not achieve the desired results. our department since 2005 January to June 2009 adopted by the transforaminal approach lumbar fusion (transforminal lumbar interbody fusion TLIF treatment of degenerative lumbar instability in 47 cases, by the follow-u
10、p observation, results were satisfactory, are as follows. Clinical data 1.1 General Information A total of 47 cases of this group of patients, including 28 males and 19 females, aged 45-69 years, mean 58.3 years, duration of 2 months to 15 years, all patients were preoperative MRI examination reveal
11、ed a lumbar disc herniation and (or ) lumbar spinal canal stenosis, and by CT, lumbar side, double oblique, hyperextension, flexion X-ray confirmed that no crack isthmus and degrees of spondylolisthesis, in line with the diagnosis of lumbar degenerative instability range of patients are low back pai
12、n, intermittent claudication (claudication symptoms 4occur -800 meters from 50 meters with unilateral or bilateral lower extremity pain, sensory loss and the corresponding control segment, a small number of patients with cauda equina syndrome. segmental instability which single segment L5 / S1 14 例,
13、 L4/L5 18 例, L3/L4 1 case, multi-segment L4/L5/S1 9 例, L2/L3/L4/L5 2 例, L3/L4/L4/L5/S1 2 cases, L1 / L2/L3/L4/L5L1 cases. 1.2 Procedures Are used endotracheal intubation, the patient stoop outside spine surgery in the bracket, C-arm to help locate, to want to reveal the center of the segment after t
14、he incision, from the spinous process, lamina subperiosteal dissection to the bilateral facet Automatic retractor retractor, designed from the preoperative lumbar segments of bilateral herringbone ridge nails into the vertex, along the direction of the pedicle into the guide pin. C-arm radiographic
15、see the location of the satisfaction of the arch to select the appropriate model nail root (Suzhou Yi Xie Yan Wing Bolt offers and pedicle and vertebral body. to have spinal stenosis and nerve root canal stenosis of the segment 5does not keep the spine ligament, posterior laminectomy, to In addition
16、 to the corresponding segment of the spinous process and lamina, bilateral facet joint to retain the integrity of the spinal canal to open a large release to loose dural sac and nerve root canal. For non-segmental spinal stenosis, keep the spine, between the ligament and the lamina integrity. line TLIF surgery Methods: degenerative scoliosis concave side of the transverse segment between the entry, with a bone knife chiseled upper part of the vertebral body
