侧后方斜向植入单枚BAK的腰椎椎体间融合术:临床初步报告

Posterior lumbar interbody fusion with single BAK insertion: a primary clinical report

目的：设计侧后方斜向植入单枚多孔螺纹状椎间融合器（ＢＡＫ）行后路腰椎体间融合术的术式，观察该方法治疗２０例下腰痛患者的初步临床疗效。方法：对２０ 例严重下腰痛（１８ 例伴下肢神经症状）的患者，采用本研究设计的术式共融合２８个椎间隙（Ｌ４～５ 间隙１６ 个，Ｌ５ ～Ｓ１ 间隙１２个），其中４例行２ 个椎节融合术的患者附加行Ｓｔｅｆｆｅｅ 钢板内固定术。结果：本组平均随访１２．５个月，除１ 例外，皆达到临床融合，均无融合器移位，患者主观满意率９０％ 。结论：侧后方斜向植入单枚多孔螺纹状椎间融合器行腰椎椎体间融合术，既能尽可能多地保留脊柱后部结构，又能充分完成后路减压，还能保证可靠的融合，不失为一种比较理想的后路腰椎椎体间融合术式。

Objective: To establish posterior lumbar interbody fusion (PLIF) by posterolateral insertion of single threaded cage(BAK) through posterior approach with unilateral facetectomy and evaluate its safety, fusion success rate and clinical outcome. Methods: For a 18 month period, 20 patients with severe low lumbar pain underwent PLIF with single posterolateral BAK insertion, 4 of them with additional instrumentation of Steffee pedicle screw fixation system. All patients were followed up from 6 to 18 months (average 12.5 months). Results: Nineteen achieved clinical fusion. Eighteen of the 20 patients had a 90% or better improvement over the preoperative symptoms. There were 2 patients had an early, substantial foot drop which disappeared within 3 months. Conclusion: PLIF by posterolateral insertion of single BAK by a posterior approach with unilateral facetectomy enables sufficient decompression and solid interbody fusion to be achieved while maintaining a majority of the posterior elements.