关键词: 椎间孔, 椎间融合术, 微创, 多裂肌

Abstract:

Objective    To explore the clinical outcome of through spatium intermuscalare of multifidus for transforaminallumbar interbody fusion.  Methods   From April 2010 to April 2012，27 patients underwent screw fixation plus transforaminallumbar interbody fusion through spatium intermusculareof multifidus. There were 12 males and 15 femaleswith the mean age of 58.2 years (range，46~74years). Among them 7 cases  hadfar-lateral lumbardisc herniation，3 cases had post-discectomy recurrence，and 17 cases had degenerative instability.  Results  The average skin incision length was 4.2 cm (range，4.0~4.5 cm)，the average operative time was 90 min(range，70~160 min)，and the average blood loss was 130 ml (range，90~250 m1)．All cases were followed up for 8~20 months (average 13.6 months)．Postoperative radiography showed no evidenceof instrument failure，and all cases got bone fusion．At final followed-up the average leg pain VAS decreased from 7.4±1.1 preoperatively to 2.4±1.3 postoperatively，the averse low back pain VAS decreased from 6.7±1.3 preoperatively to 1.8±1.5 postoperatively． According to Nakai ncriterion，22 cases were rated asexcellent，3 cases as good，and 2 case as fair with the total excellent and good rate of 92.6％. Conclusions   Transforaminallumbar interbody fusion  through spatium intermusculareof multifidus  has some advantages of minimal invasiveness，less blood loss，less complications and reliable curative effect．It is a satisfactory lumbarfusion method undersuitable indication．

Key words: Foramen intervertebrale, Interbody fusion, Minimally invasive, Muhifidus muscle