MIS-TLIF治疗腰椎退变性疾病的研究进展

Current research on MIS-TLIF for treatment of lumbar degenerative disease

本文通过检索国内外相关文献来综述MIS-TLIF治疗腰椎退变性疾病的解剖入路、临床应用和技术革新。手术者多采用多裂肌与最长肌之间的Wiltse间隙入路。该术式除了用于治疗单纯单节段腰椎间盘突出症,还在治疗多节段腰椎管狭窄、腰椎滑脱、胸腰段间盘突出症、成人退变性脊柱侧凸等方面有优势。近几年的技术革新多集中在内固定方式和减少术中辐射量上,并取得了许多成果。MIS-TLIF因其组织损伤小和患者恢复早的特点被广泛应用,当然它也有学习曲线陡峭、术中辐射大等不足之处。其远期疗效还需大量多中心、前瞻性的研究进一步证实。

The present paper aimed to summarize the anatomic approach, clinical application and technical innovation of minimally invasive transforaminal lumbar interbody fusion （MIS-TLIF） for lumbar degenerative diseases according to relevant literature at home and abroad. Surgeons often create the minimally invasive channel system through the Wihse space between muhifidus and longissimus muscles, which take advantages not only in simple discectomy for a single level of lumbar disc herniation, but also for muhisegment lumbar spinal stenosis, lumbar spondylolisthesis, thoracolumbar disc herniation, adult degenerative scoliosis and so on. Technical innovations in recent years, more focus on fixation and reduction of intraoperative radiation with lots of achievements. MIS-TLIF has been widely used due to less tissue injury and early recovery, but it has a steep learning curve, intraoperative radiation and other shortcomings. A large number of muhicenter and prospective studies should be performed to confirm the long-term efficacy.