The Therapy Of Lumbar Spondylolisthesis With PLIF Through Posterior Sole Small Incision Of Mocroendoscopic Discectomy

BackgroundSpinal interbody fusion technology is aways widely applied to spinal diseases.As far back as the early nineteenth century, the Spinal interbody fusion technology was invented,and was improved henceforth.On that basis,anterior lumber interbody fusion(ALIF),posterior lumber interbody fusion(PLIF),between the bone graft hattushposter fusion and 360 arthrodesis-were invented one after another, which-performed great clinicl results.And PLIF is one of the therapies,which is extensively used.PLIF was proposed by Jaslow,who was American,for the first time.After improvement and development for decades,the technology has increasingly mature.because of its advantages, relatively simple commits and great curative effect,etc,it is very popular in the incomparable spinal orthopaedic surgeons and patients of all ages.While the pedicle screws fixation system(PSFS) was first developed by the French scholars Roy-Camille in 1963,and has developed fore more than 40 years of history. After almost half a century of development,the pedicle screws internal fixation(PSIF)is almost perfect.Now it is widely used in the surgical treatment of spinal disorders,especially applied to spine fracture,deformity, infection, spinal tumors and various neurodegenera-tive diseases,etc,for its solid and stable spinal 3d fixation and excellent deformity correction functions. Foly and Smith developed microendoscopic discectomy in 1997.As thetechnology becomeingperfect, the indications continued to edpand.In the early,it only can be applied to single segment protrusion of the lumber intervertebral disc,but now it can be used to the treatment of complex prolapse of lumber intervertebral disc,lumber spinal stenosis disease, lumbar olisthe sickness Within three segment and so on.In recent two years,we tried to The Therapy of lumbar spondylolisthesis with PILIF through posterior sole small incision of microendoscopic discectomy on the typical single segment lumbar olisthe disease patients and succeed,aiming to seek a more ideal new lumbar diseases minimally invasive surgical thrapy.ObjectiveWe put PLIF technology and MED technologies combining and apply it to patients,Aiming to find its maneuverability and curative effect of the technology of the therapy of lumbar spondylolisthesis with PLIF through posterior sole small incision of microendoscopic discectomy.Methods1 The selection of typical patientFrom September 2009 to December 2010,we found 15 typica cases from all protrasion of the lumbar intervertebral disci patients. Selection standards:Single segment lumbar olisthe with out Prolapse of lumbar intervertebral disc, lumbar spinal stenosis disease and any other disease which may impact the assessment of surgical curative effect. Among them6 were men, female 9 cases, range in age from 18-65 years old(average age is 37.6); slippage in 5 patients, andⅡ。slippage in 8 cases,2 casesⅢ。above spondylolisthesis, Isthmic 6 cases didn't even.2 preoperotive preparationEach patient all perfect routine examination and lumbar preoperative imaging specialized examination,farther diagnose, and eliminate absolute operation contraindication disease.And get pethidine 80mg and Parecoxib Sodium 40mg intramuscular injections 30minutes before operation for preemptive analgesia.3 Operation processPositioning lesions vertebral clearance with a 10ml needle in C arm X-ray machine guidance.Then disinfect and Spread towels around the needle.All 15 patient accepted the operationthrough t posterior sole small incision of microendoscopic discectomy under the condition of the local anesthesia.ResultsAll 15 patients accept the Minimally invasive surgery, successfully completed lumbar olisthe reset fixation At the time of the operation 245min (average for 110-170min);The bleeding 170-685 ml (average bleeding 315ml); Postoperative slippage completely resetⅡcases, not completely reset 4 cases.Follow-up for 3-26 months (mean 13.7 months).the end time, using Macnab standard follow-up evaluation curative effect:optimal 13 cases "good" in 1 case, but in one.ConclusionTreating the lumbar olisthe disease through Posterior Sole small Incision of Microendoscopic Discectomy by PLIF and Pedicle screw placement fixation with self-made minimally invasive placement equipment has lots ofadvantages,suah as small trauma, with less bleeding, faster recovery, sequela is less, etc.And it is a feasible minimally invasive treatment lumbar olisthe disease operation mode.