頁籤選單縮合
題 名 | Is Posterior Lumbar Interbody Fusion with Titanium Cages Alone Suitable for Lumbar Degenerative Disease?=後位椎體融合手術單獨使用Cage對於退化性脊椎疾病是否適合? |
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作 者 | 林瑞峰; 張丞圭; 蔡承嘉; 陳旭照; | 書刊名 | 臺灣外科醫學會雜誌 |
卷 期 | 41:6 2008.11-12[民97.11-12] |
頁 次 | 頁267-274 |
分類號 | 416.61 |
關鍵詞 | 脊椎後位融合手術; 退化性脊椎疾病; PLIF; Cage alone; Lumbar degenerative disease; |
語 文 | 英文(English) |
中文摘要 | 脊椎後位融合手術被應用在各種不同的退化性脊椎疾病,病人有一節或是兩節的椎問盤突出、單側或是雙側下肢痛、慢性下背痛並且保守治療無效的病人皆適用此一治療方式。此篇論文討論病人在幾節脊椎病變的情況下適合用cage alone的方式做椎體融合手術,以及哪一節有較好的預後。23位病人在接受手術治療前,病人都有明確神經學症狀,保守治療無效,並經由MRI檢查確立診斷。所有病人無重大併發症並且術後穩定追蹤。在單一節數的病人都獲得滿意的結果,對於兩節的病人,有一位在第18個月時接受TPS之固定融合手術,以及另一位在接受保守治療兩年後下背痛及神經症狀都獲得改善。由我們的追蹤發現,接受單一節數的手術病人預後比兩節好,且L3/4及L4/5的預後比L5/S1好。此項手術方式對病人的神經學症狀改善是令人滿意的,而且術後沒有滑脫的情況,也能維持適當的椎間盤高度及椎孔大小。因此,此項手術對於此類病人是適當且有效的。 |
英文摘要 | Objective: Posterior lumbar interbody fusion (PLIF) techniques have been used for many years for the treatment of a variety of lumbar spine degenerative diseases. Patients with herniated disc disease in the lumbar spine at one or two levels, unilateral or bilateral leg (s) pain, chronic low back pain and a failed conservative treatment, were considered for this procedure. This paper discusses how many levels of the spine are suitable for cages alone which the patient needs for the operation, and which level is better than others when the patient undergoes single-level surgery. Methods: Twenty-three patients (21: single level, 2: two levels) underwent a posterior lumbar interbody fusion procedure in which A-spine titanium vigor cages were used. At follow-up, the outcomes were assessed using the Prolo Scale. All the patients safely underwent surgery without severe complications. Results: At the time of the last follow-up visit, 21 patients (100% of single-level cases) were content with the result of the surgery. A patient (2-level case) underwent pedicle screw fixation at a single level due to persistent lower back pain (LBP), which pseudarthrosis was suspected. During the follow-up period, the patients who underwent 2-level surgery have multiple complaints. The other patient (female, 2- level case) suffered from LBP for 24 months. Under conservative treatment, low back pain improved. Conclusion: With regard to the preservation of the posterior element for utmost benefits, a single-level operation has a better prognosis than a two-level operation. In single level surgery, a PLIF by cages alone produces more satisfactory clinical results at L3/4 and L4/5 than at L5/S1. |
本系統中英文摘要資訊取自各篇刊載內容。