经椎间孔入路腰椎体间融合治疗下腰椎退变

Transforaminal lumbar interbody fusion for the treatment of degenerative diseases of lower lumbar spine

目的 总结经椎间孔入路腰椎体间融合治疗下腰椎退变的临床效果。方法 采用半椎板或全椎板切除、经椎间孔入路腰椎体间融合、椎弓根螺钉固定治疗下腰椎退变患者26例。结果 26例随访4～28个月，平均11个月。临床评价：优13例，良12例，尚可1例。无1例出现永久性神经损伤手术并发症。术后X线片显示植骨密度随术后时间的延长而加深，钛网融合器无下陷，椎间隙高度无丢失，椎弓根螺钉系统无断裂和移位。结论 经椎间孔入路腰椎体间融合治疗下腰椎退变创伤小，并发症少，临床效果较好。

Objective To summarize the treatment effect of degeneration of lower lumbar spine with transforaminal lumbar interbody fusion（TLIF）. Methods 26 patients with degenerative diseases of lower lumbar spine were treated with laminectomy or hemilaminectomy,TLIF and pedicular screw internal fixation. Results The follow-up period averaged 11 months （ range ,4 - 28 months）. Of the 26 study patients, the results were excellent in 13 cases, good in 12 and fair in 1 ,and there was no patients suffered from permanent neurologic injuries after the procedure. Postoperative radiograph of the patient＇s lumbar spine showed that the bone mineral density in the disc space had gradually increased,and no cage sinking,loss of the height of disc space, or pedicular screw breakage or displacement was found. Conclusions TLIF has advantages of less operative trauma,less complications and better clinical result.