前路腰椎椎间融合的理论研究及其治疗进展

Theoretical research and treatment progress of anterior lumbar interbody fusion

背景:前路腰椎椎间融合已成为一种椎间融合的标准技术,广泛应用于椎体滑脱、椎间盘源性疼痛、腰椎失稳等病症的治疗。目的:归纳总结前路椎间融合器的种类、前路腰椎椎间融合的临床应用及内固定器械种类等方面的研究进展。方法:以"anterior lumbar interbody fusion"为检索词,检索PubMed数据库(1979年1月至2012年1月)。以"前路腰椎椎间融合术"为检索词,检索万方数据库(1979年1月至2012年1月)。文献语种限制为英文和中文。结果与结论:计算机初检得到567篇文献,根据纳入排除标准,对39篇文献进行分析。近年来,前路腰椎椎间融合在临床应用方面及椎间融合器自外形到材料等都有很大发展,椎间融合率不断提高;多种内固定器械开始用于临床以增强前路融合的稳定性;小切口术式的临床应用,腹腔镜下手术的开展,使手术趋向微创化。

BACKGROUND： Anterior lumbar interbody fusion has become a standard technique for interbody fusion. Now it is widely used for the treatment of many degenerative diseases, such as isthmic spondylolisthesis, lumbar discogenic pain and lumbar instability. OBJECTIVE： To summarize research progress of species and application of anterior lumbar interbody fusion device as well as the species of internal fixation devices. METHODS： The PubMed database （1979-01/2012-01） was retrieved with the key word of ＂anterior lumbar interbody fusion＂ in Chinese. Literatures were limited to English and Chinese languages. RESULTS AND CONCLUSION： Totally 567 literatures were obtained from the initial computer screen, and 39 documents of them were involved for analysis according to the inclusion and exclusion criteria. Recently, we have obtained significant development on the application of anterior lumbar interbody fusion, as well as the appearance and the material of interbody fusion device, the interbody fusion rate developed continuously. A variety of internal fixation devices have applied in clinic to enhance the stability of anterior fusion; the clinical application of small-incision surgery and the development of laparoscopic surgery make the surgery tend to minimal invasion.