Hybrid手术治疗多节段腰椎退变性疾病的研究进展

Research progress on Hybrid surgery for the treatment of multilevel lumbar degenerative diseases

传统腰椎融合术因破坏了脊柱的生物力学性能,可能会加速邻近节段退变(adjacent segment degeneration,ASD),尤其对于多节段融合的患者而言风险更大。而腰椎非融合技术的应用尚处于不成熟阶段,其适应证比较局限,并带来一些新的并发症,多节段应用时更存在着诸多不足。近年来,融合与非融合技术联合应用的Hybrid手术(hybrid surgery,HS)治疗多节段腰椎退变性疾病逐渐增多,以期该术式能够综合二者优势,在坚强固定脊柱的同时保留部分节段的活动度,减少融合节段的数量,从而延缓ASD。本文对HS治疗多节段腰椎退变性疾病的生物力学及临床研究进展做一综述。

Traditional lumbar fusion destroys the biomechanical properties of the spine, which could accelerate adjacent segment degeneration （ASD） especially in patients undergoing multi-segmental fusion. The application of lumbar nonfusion is still in the immature stage with limited indications and new complications, let alone the disadvantages when it is applied to patients with multilevel disc degeneration. In recent years, Hybrid surgery, combining the fusion or nonfusion, has been increasingly used for the treatment of multilevel lumbar degenerative diseases, which is expected to integrate the advantages of two approaches. This procedure aims at rigidly fixing the spine while keeping motions of some segments, reducing fused segments, thus delaying the progression of ASD. This paper reviews the biomeehanical and clinical research progress of Hy- brid surgery for multilevel lumbar degenerative diseases.