L_(5)~S_(1)椎间融合前方入路术前血管评估的研究进展  

Research progress of preoperative vascular evaluation of L5-S1 anterior approach interbody fusion

作　　者：马裕俭 施志约 李吴耀 代兴飞 李啟堂 严荣爽 潘呈 费德锐 张颖[1] MA Yu-jian;SHI Zhi-yue;LI Wu-yao;DAI Xing-fei;LI Qi-tang;YAN Rong-shuang;PAN Cheng;FEI De-rui;ZHANG Ying(Department of Orthopaedics,The Second Affiliated Hospital of Kunming Medical University,Kunming,Yunnan,650033,China)

机构地区：[1]昆明医科大学第二附属医院骨科,云南省650033

出　　处：《中国骨与关节杂志》2023年第11期868-873,共6页Chinese Journal of Bone and Joint

基　　金：国家自然科学基金(82060414);昆明医科大学联合专项-面上项目(202101AY070001-150)。

摘　　要：腰椎融合术结合椎弓根钉棒系统内固定术是临床上治疗退行性病变、感染、创伤和肿瘤等各种腰椎疾病的基本术式[1]。前路腰椎椎间融合术(anterior lumbar interbody fusion,ALIF)和斜外侧入路腰椎椎间融合术(oblique lateral interbody fusion,OLIF)都是通过腰椎横突前方进入椎间盘的,前方入路较后方入路可提供简单且完整的椎间盘准备并获得很高的融合率,可显著纠正冠状面和矢状面的失衡,可植入较大面积和体积的融合器有效恢复椎间隙和椎间孔高度从而实现间接减压效果。尤其是OLIF,通过腰大肌与主动脉之间的天然解剖间隙进入椎间盘,具有组织损伤小、手术时间短、出血量少、住院时间短、术后腰痛较轻、恢复快、融合率高、cage沉降率低、改善放射学参数等优势[2-4],因此OLIF在L2~5节段特别适合,临床也广泛开展。Being minimally invasive,the oblique lateral lumbar fusion(OLIF)has been widely used in L2-5 segment.Due to the complexity of L5-S1 anatomical structure of vessels,neither OLIF nor anterior lumbar interbody fusion(ALIF)has yet been widely applied in the treatment of degenerative lumbar disease.Based on limited literatures,the incidence of complications is not low,especially the vascular injury with disastrous consequences.This article reviews the preoperative evaluation of vascular structure for L5-S1 anterior approach surgery(ALIF/OLIF),aiming to improve the safety of the operation.

关 键 词：腰椎 脊柱融合术 血管 综述 

分 类 号：R687.3[医药卫生—骨科学]