一种疼痛少，恢复快，疤痕小的微创脊柱融合术

  一种微创脊柱融合手术可以减少出血量、降低手术后疼痛、使得患者的伤口较小、住院时间缩短，并且同时可以帮助患者迅速恢复；并不通过脊椎后部的肌肉切开，医生们就可以使得肌肉膨胀来获取进入腰椎的入口，这种操作就是微创经椎间孔腰椎体间融合术（MIS-TLIF）。

  来自洛约拉大学 ( Loyola University)医学中心的研究人员表示，MIS-TLIF是一种具有陡峭学习曲线的复杂操作步骤，当我们同加利福尼亚大学共同完成微创和复杂的脊椎手术后才对这种技术进行了深入的学习；病人William Hoecker就是研究者进行研究通过MIS-TLIF技术获益的其中一位病人，该病人遭受了由退行性脊柱滑脱及脊椎狭窄引发的下肢麻木及疼痛。

  脊髓中一块椎骨从位于其下部的另一块椎骨滑落后，就会挤压神经根部，引发下肢疼痛，对于这位患者而言，当其走25英尺后，其下肢就会变得非常疼痛而不得不坐下或者躺下进行休息，通常情况下William Hoecker不能够驾驶超过20分钟；这项研究中，研究者Amin将患者Hoecker腰部的L4和L5两块椎骨进行了融合，首先研究者对脊椎的神经根进行了降压操作，移除了两个椎骨间的椎间盘，然后将一种充满骨移植物的植入物置于两块椎骨间，同时研究者还植入了保护杆和“螺丝”来固定保护椎骨，随着骨移植物开始愈合，其就会将两块椎骨进行融合，形成单一的骨头。

  这种名为MIS-TLIF的融合手术可以明显改善患者的生活质量，如今经过治疗的William Hoecker可以像正常人一样行走以及驾驶了，实际上他还计划步行去迪斯尼世界，他对自己的恢复非常有信心，坚信自己的生活状态可以赶得上自己的孙子。（转化医学网360zhyx.com）

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A minimally invasive spinal fusion back surgery results in less blood loss, less postoperative pain, smaller incisions, a shorter hospital stay and faster recovery and return to work.

Rather than cutting through paraspinal (back) muscles, the surgeon spreads and dilates the muscles to obtain access to the lumbar (lower back) spine. One such operation is called a minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).

It's a complex procedure with a steep learning curve, said Loyola University Medical Center spine surgeon Beejal Amin, MD, who has given talks about the procedure around the country. Dr. Amin is first author of an abstract and surgical video about the procedure in Neurosurgical Focus, a publication of the American Association of Neurosurgeons. (Click here to see the 3D video: http://youtu.be/LYRU9lbBdNg )

Dr. Amin learned the procedure while completing a fellowship in minimally invasive and complex spine surgery at the University of California at San Francisco Medical Center.

Patient William Hoecker is among Dr. Amin's patients who have greatly benefited from the procedure. Mr. Hoecker suffered debilitating leg pain and numbness due to degenerative spondylolisthesis and spinal stenosis. One vertebra had slipped forward over the vertebra below it, pinching the nerve root and causing pain in the left leg. For Mr. Hoecker, walking just 25 feet was so painful he would have to sit or lie down. He was unable to drive for more than 20 minutes. "I was stuck in my house," he said.

Dr. Amin fused the L4 and L5 vertebrae in Mr. Hoecker's lower back. First, he decompressed the spinal nerve roots. Next, he removed the degenerated disc between the two vertebrae. Then an implant filled with bone graft was placed in the empty disc space between the vertebrae. Dr. Amin implanted rods and screws to hold the vertebrae together. As the bone graft healed, it fused the two vertebrae together, resulting in a single bone.

The surgery dramatically improved Mr. Hoecker's quality of life. He now can walk or drive without limitations. Indeed, he's planning a road trip to Disneyworld, and is confident he will be able to keep up with his grandchildren.