A prospective 2-5 years follow-up study of video-assisted minimally invasive total lumbar disc replacement for lumbar degenerative disc disease,with special reference to the spinal sagittal balance
作者单位：Department of spinal surgeryTianjin HospitaTianjin 300211China
会议名称：《第八届全国脊柱脊髓损伤学术会议》
会议日期：2007年
学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学]
关 键 词：lumbar spine disc prosthesis video-assisted outcome
摘 要：Objective To evaluate the clinical results of total disk replacement(TDR)and its influence on spinal sagittal *** From January 2002 to February 2005, video-assisted retroperitoneal minimally invasive TDR with Maverick prosthesis was performed for 135 cases of lumbar degenerative disc disease (DDD).The average follow-up was 3.5 years(range 2-5 years).The clinical results were evaluated with Oswestry scale,visual analog scale(VAS)for lumbar and leg pain,and SF *** degenerations of disc,facets and paravertebral muscles were evaluated and graded on MRI scans preoperatively. The preoperative and postoperative radiographic evaluation included flexion-extension films of lumbar spine and standing anteroposterior and lateral full spine films that included the femoral *** The mean operating time for single level TDR was 60min,and the intraoperative blood loss averaged 170ml for all the cases. Intraoperative complications included one ureter lesion that was successfully repaired and 5 sympatheticus chains *** were 4 cases of postoperative root pain and one case of superficial infection,and all of them resolved with conservative treatments. During follow-up,17 patients received posterior facet infiltration(11 with good results),3 patients underwent posterior fusion at TDR level due to progressive degeneration of facets,1 patient underwent anterior fusion at adjacent level due to degeneration of disc,and 3 patients had spinal pain other than in the lumbar *** mean Oswestry score improved from 46.6% preoperatively to 23.2% at final follow-up,low back pain and leg pain improved from a mean VAS of 7.6 and 3.6 preoperatively to 2.7 and 1.9 at final follow-up,*** success rate was 75.6% according to the FDA criteria(25% improvement of Oswestry score).The grade 1 and 2 degeneration of facet did not influence clinical results,but the grade 3 and 4 degeneration of paravertebral muscle correlated to poor *** mean mobility in