一期后路开放联合前路腹腔镜辅助下椎间融合技术在治疗腰椎疾患中的应用

目的 评价一期后路开放联合前路腹腔镜辅助下椎间融合技术在治疗腰椎疾惠中的临床效果。方法 回顾性分析该科自1999年12月～2001年1月应用此项技术治疗的27例腰椎疾患病人，其中男11例，女16例，平均年龄42．5岁，腰椎滑脱症17例，椎间盘炎4例，结核3例，椎间盘突出合并腰椎不稳2例，陈旧性压缩性骨折合并顽固性腰痛、不稳1例。前路椎间融合材料：自体髂骨10例，BAK17例，所有病人均在全麻下行一期后路开放手术，前路腹腔镜辅助下椎间融合。结果 所有病人获随访6—12个月，平均8个月，术后病人的临床症状均得到明显改善，无感染，脑脊液漏及神经系统并发症。随访影像学资料提示病变部位的腰椎均获得了良好稳定和椎间融合，无内固定失败和椎间融合器下沉与脱出，假关节形成等并发症。结论 一期后路开放联合前路腹腔镜辅助下椎间融合技术，可以在最大限度减少神经系统并发症和创伤基础上，获得病变腰椎良好的生物力学稳定性和临床治疗效果。

One-stage open posterior and endoscopic anterior fusion with interbody implants for the treatment of lumbar diseases

Objective: To evaluate the efficacy and safety with one-stage posterior and endoscopic anterior fusion with interbody implants for the treatment of lumbar diseases.Methods: Retrospective analyze twenty-seven patients with lumbar disease, From Dec.1999 to Jan. 2001, treated with this technique. Of these patients, 11 males and 16 females, aged from 38 to 61 years old, mean 42.5 years. These were 17 cases of lumbar spondylolisthesis,4 cases of disc inflammation,3 cases of TB, 2 cases of lumbar disc herniation with lumbar unstability and 1 case of unfresh fracture with sternosis and unstability. Anterior interbody fusion: ilium 10, BAK 17, all cases were treated by one-stage open posterior methods combined with anterior laparoscopic surgery.Results: The patients were followed up from 6 to 12 months(mean 8 months).The pre-operative clinical symptoms disappeared completely partially. No infection,CSF leak and neurologic complication with all patients. All patients obtained excellent spinal stability and spinal fusion. No implant fracture,BAK dislocation and pseudarrosis. Conclusion: Minimally invasive laparoscopic spine surgery in the treatment of lumbar diseases is effective and safe technique.