OLIF技术在腰椎退行性疾病中的应用PPT课件.pptx

OLIF技术及其在腰椎退行性疾病中的应用

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;Introduction;PLIF;ALIF;TechniquereviewOLIF;psoasmajor腰大肌;8;9;OLIFcorridorinthestaticstate;OLIFcorridorwithmildpsoasretraction;OLIFapproachanatomy;OLIFapproachanatomy;;;IVC下腔静脉;IndicationsofOLIF;OLIFprocedures

Lateraldecubitusposition?

Left／rightsideandconvex／concaveside

4-5cmskinincisionforupto3levelscanbeaddressedthrougha“slidingwindow”

Bluntdissectiontheretroperitonealspace

OLIFsystem

Endplatepreservation

Totallyreleaseofcontralateralannulus

Bluntdilationofintervertebralspace

Cagewithconsiderablesize

;Position体位;SilvestreC,Mac-ThiongJM,HilmiR,etal.Complicationsandmorbiditiesofmini-openanteriorretroperitoneallumbarinterbodyfusion:obliquelumbarinterbodyfusionin179patients.AsianSpineJ2012;6:89–97.(FirstreportofOLIF);根据左侧或右侧入路切口大致为反麦氏点或麦氏点，可通过透视选择恰当的手术节段与切口。;Dissecting分离;TheOLIFsystemandobliquecorridorsetup

建立OLIF通道，处理椎间盘。

如果间盘严重塌陷，可使用撑开钳逐级撑开，并恢复正常椎间隙高度,恢复前凸并扩大椎间孔。

前纵韧带与后纵韧带必须保持完整。间盘切除后,使用骨锉清除终板表面的软骨层，直至骨面出血，避免过度清除软骨下骨质使骨性终板变弱。

如完全清除终板，可能导致沉降与节段失稳！

;术中再次透视确认手术节段;Endplatepreservationandcageinsertion;MeritsandDemeritsOLIFComparedwithOtherSurgeries;27;FeaturesinOLIFoperation;ConcernsofOLIF;30;31;32;Time;34;ConcernsofOLIF;36;ConcernsofOLIF;ConcernsofOLIF;ConcernsofOLIF;ConcernsofOLIF;ConcernsofOLIF;Preoperative(left)andpostoperative(right)standingPAlong-cassettescoliosisseriesradiographsinapatientwhounderwentacombinedapproachwithminimallyinvasivetranspsoasXLIFandopenposteriorsegmentalpediclescrewinstrumentationforcorrectionofadultdegenerativescoliosis.AsatisfactorycorrectionincoronalCobb

angle,AVTwasachieved.;ConcernsofOLIF;ConcernsofOLIF;ConcernsofOLIF;ConcernsofOLIF;Female,70y/oZangXX

Present