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Q⁃TLIF技术的临床应用与展望
Clinical application and prospect of Q⁃TLIF technique

广西医学 页码:470-474

作者机构:黄先盈,博士,住院医师,研究方向为脊柱退行性疾病微创治疗。

DOI:10.11675/j.issn.0253-4304.2024.04.03

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  • 英文简介
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进入21世纪以来,腰椎微创技术在全球范围内应用广泛,腰椎融合技术层出不穷,包括前路腰椎椎间孔融合术、斜外侧腰椎椎间融合术、微创经椎间孔腰椎椎间融合术、极外侧椎体间融合术、脊柱内镜下经后路椎板间入路腰椎椎体间融合术(Endo⁃P/TLIF)、单边双通道内镜下腰椎椎间融合术(UBELIF)、V形双通道内镜下腰椎椎间融合术(VBELIF)等,其中Endo⁃P/TLIF、UBELIF、VBELIF是近年来较为热门的后外侧入路微创腰椎椎间融合术式。然而,目前所有术式均无法实现在椎间盘内直接进行椎间盘处理、植骨床准备和融合器植入,因此无法避免这些操作所致的神经根损伤风险。本研究团队研发一套经皮腰椎融合器械,可实现直接Kambin三角撑开、直接椎间隙撑开、直接椎间盘切除、直接植骨床处理、直接植骨及植入融合器这些关键手术步骤。基于经皮腰椎融合器械的5个“直接”优势,提出一个创新术式——快速经椎间孔入路腰椎椎间融合术。

Since the 21st century, minimally invasive techniques of lumbar spine have been widely used worldwide, and lumbar fusion techniques have emerged in endlessly, including anterior lumbar interbody fusion, obilique lumbar interbody fusion, minimally invasive⁃transforaminal lumbar interbody fusion, extreme lumbar interbody fusion, endoscopic⁃posterior/transforaminal lumbar interbody fusion (Endo⁃P/TLIF), unilateral binary channel endoscopy lumbar interbody fusion (UBELIF), V⁃shape binary channel endoscopy lumbar interbody fusion (VBELIF), etc., therein Endo⁃P/TLIF, UBELIF and VBELIF are relatively popular minimally invasive surgical methods of lumbar interbody fusion via posterior lateral approach in recent years. However, none of the current surgical methods can achieve direct intervertebral disc treatment, bone graft bed preparation, and fusion implantation in the intervertebral disc, therefore it is impossible to avoid the risk of nerve root injury caused by these procedures. Our research team developed a set of percutaneous lumbar fusion instruments, which can achieved the key procedures of direct Kambin triangle distension, direct intervertebral disc distension, direct discectomy, direct bone graft bed treatment, and implantation of direct bone graft and fusion. Based on the five “direct” advantages of percutaneous lumbar fusion instruments, an innovative procedure, namely, quick transforaminal lumbar interbody fusion, is proposed.

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