侧方椎间融合技术治疗成人退变性脊柱侧凸:焦点与争议

Lateral lumbar interbody fusion for the treatment of adult degenerative scoliosis: focus and controversy

成人退变性脊柱侧凸(adult degenerative scoliosis,ADS)好发于50岁以上人群,其病理基础是椎间盘及小关节的非对称性退变,常常伴有腰椎椎管狭窄,椎体侧方滑移等[1-5]。ADS患者的临床症状主要为顽固性腰背痛、间歇性跛行、下肢放射痛以及进行性脊柱侧后凸畸形。目前随着社会发展及人口老龄化,ADS患者已经越来越多,其也成为影响中老年人生活质量的一个重要疾病。目前,临床上ADS患者的保守治疗效果欠佳,往往需要手术治疗[6-11]。

In recent years,lumbar lateral lumbar interbody fusion (LLIF) has been widely used in the treatment of various lumbar degenerative diseases including adult degenerative scoliosis (ADS) because of its advantages in indirect decompression and restoration of sagittal and coronal plane balance.At present,researchers have conducted many in-depth studies on LLIF treating ADS,but there are still considerable controversies in many aspects.This article reviews the indications,contraindications,clinical efficacy,restoration of coronal and sagittal balance,surgical strategy,surgery approach and complications of LLIF in the treatment of ADS,providing the latest focus and controversy.