{"title":"用于翻修手术的微创椎间孔外腰椎椎体融合术:通过 Kambin 三角形的技术。","authors":"Jun Gue Lee, Hyeun Sung Kim, Seok Won Kim","doi":"10.14245/kjs.2015.12.4.267","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to evaluate the clinical outcomes of minimally invasive extraforaminal lumbar interbody fusion (ELIF) for revision surgery.</p><p><strong>Methods: </strong>From January 2011 to December 2012, 12 patients who underwent minimally invasive ELIF through the Kambin's triangle for revision surgery were included in this study. All patients underwent the surgical procedure in the following sequence: (1) epidural anesthesia, (2) exposing the Kambin's triangle toward the lateral part of the dura (partial resection of the superior articular process), (3) bilateral cage insertion for reinforcement of stabilization and fusion, and (4) percutaneous transpedicular screwing. Clinical outcomes were assessed using the visual analogue scale (VAS), and Oswestry disability index (ODI). Imaging and clinical findings including surgical techniques, clinical outcomes, and related complications were depicted and analyzed.</p><p><strong>Results: </strong>The mean age of the patients (5 men, 7 women) was 60.7±13.4 years, and the mean follow-up period was 27.1±4.9 months. The mean VAS (back and leg) score improved significantly at final follow-up. The mean ODI score decreased as follows: preoperative, 76.78±6.08; 3 months after the surgery, 37.74±6.67; and at final follow-up, 29.91±2.98. Two patients presented with transient nerve root irritation, but there were no cases of incidental dural tear or serious infection. No significant neurological deterioration or major complication was noted in any of the patients.</p><p><strong>Conclusion: </strong>Minimally invasive ELIF for revision surgery is an effective surgical option with a low complication rate.</p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4731562/pdf/","citationCount":"0","resultStr":"{\"title\":\"Minimally Invasive Extraforaminal Lumbar Interbody Fusion for Revision Surgery: A Technique through Kambin's Triangle.\",\"authors\":\"Jun Gue Lee, Hyeun Sung Kim, Seok Won Kim\",\"doi\":\"10.14245/kjs.2015.12.4.267\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The purpose of this study was to evaluate the clinical outcomes of minimally invasive extraforaminal lumbar interbody fusion (ELIF) for revision surgery.</p><p><strong>Methods: </strong>From January 2011 to December 2012, 12 patients who underwent minimally invasive ELIF through the Kambin's triangle for revision surgery were included in this study. All patients underwent the surgical procedure in the following sequence: (1) epidural anesthesia, (2) exposing the Kambin's triangle toward the lateral part of the dura (partial resection of the superior articular process), (3) bilateral cage insertion for reinforcement of stabilization and fusion, and (4) percutaneous transpedicular screwing. Clinical outcomes were assessed using the visual analogue scale (VAS), and Oswestry disability index (ODI). Imaging and clinical findings including surgical techniques, clinical outcomes, and related complications were depicted and analyzed.</p><p><strong>Results: </strong>The mean age of the patients (5 men, 7 women) was 60.7±13.4 years, and the mean follow-up period was 27.1±4.9 months. The mean VAS (back and leg) score improved significantly at final follow-up. The mean ODI score decreased as follows: preoperative, 76.78±6.08; 3 months after the surgery, 37.74±6.67; and at final follow-up, 29.91±2.98. Two patients presented with transient nerve root irritation, but there were no cases of incidental dural tear or serious infection. No significant neurological deterioration or major complication was noted in any of the patients.</p><p><strong>Conclusion: </strong>Minimally invasive ELIF for revision surgery is an effective surgical option with a low complication rate.</p>\",\"PeriodicalId\":17867,\"journal\":{\"name\":\"Korean Journal of Spine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2015-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4731562/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Korean Journal of Spine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14245/kjs.2015.12.4.267\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2015/12/31 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Korean Journal of Spine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14245/kjs.2015.12.4.267","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2015/12/31 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
研究目的本研究旨在评估微创椎间孔外腰椎椎体融合术(ELIF)翻修手术的临床效果:2011年1月至2012年12月,12名患者接受了经Kambin三角区微创ELIF翻修手术。所有患者均按以下顺序进行了手术:(1)硬膜外麻醉;(2)向硬脑膜外侧暴露Kambin三角区(部分切除上关节突);(3)插入双侧骨笼以加强稳定和融合;(4)经皮经关节螺钉固定。临床结果采用视觉模拟量表(VAS)和Oswestry残疾指数(ODI)进行评估。对包括手术技术、临床疗效和相关并发症在内的影像学和临床结果进行了描述和分析:患者(5 名男性,7 名女性)的平均年龄为(60.7±13.4)岁,平均随访时间为(27.1±4.9)个月。在最后的随访中,VAS(背部和腿部)平均得分明显提高。平均 ODI 评分下降情况如下:术前,76.78±6.08;术后 3 个月,37.74±6.67;最后随访时,29.91±2.98。两名患者出现了一过性神经根刺激症状,但没有发生硬膜撕裂或严重感染。所有患者均未出现明显的神经功能恶化或重大并发症:微创ELIF翻修手术是一种并发症发生率较低的有效手术方案。
Minimally Invasive Extraforaminal Lumbar Interbody Fusion for Revision Surgery: A Technique through Kambin's Triangle.
Objective: The purpose of this study was to evaluate the clinical outcomes of minimally invasive extraforaminal lumbar interbody fusion (ELIF) for revision surgery.
Methods: From January 2011 to December 2012, 12 patients who underwent minimally invasive ELIF through the Kambin's triangle for revision surgery were included in this study. All patients underwent the surgical procedure in the following sequence: (1) epidural anesthesia, (2) exposing the Kambin's triangle toward the lateral part of the dura (partial resection of the superior articular process), (3) bilateral cage insertion for reinforcement of stabilization and fusion, and (4) percutaneous transpedicular screwing. Clinical outcomes were assessed using the visual analogue scale (VAS), and Oswestry disability index (ODI). Imaging and clinical findings including surgical techniques, clinical outcomes, and related complications were depicted and analyzed.
Results: The mean age of the patients (5 men, 7 women) was 60.7±13.4 years, and the mean follow-up period was 27.1±4.9 months. The mean VAS (back and leg) score improved significantly at final follow-up. The mean ODI score decreased as follows: preoperative, 76.78±6.08; 3 months after the surgery, 37.74±6.67; and at final follow-up, 29.91±2.98. Two patients presented with transient nerve root irritation, but there were no cases of incidental dural tear or serious infection. No significant neurological deterioration or major complication was noted in any of the patients.
Conclusion: Minimally invasive ELIF for revision surgery is an effective surgical option with a low complication rate.