The manipulation techniques of circumferential fusion following discectomy at L5-S1 level for a L5-S1 disc herniation patient with club-shaped L5 spinal process and S1 spina bifida occulta were explored.The patient was a 43-year-old male.Following a traditional posterior midline open approach to deep fascia layer,sacral spine muscle dissection was first done at L5 lamina where normal anatomic structure remained,then downward to the S1 spina bifida occula area initially along the lateral area where S1 lamina remnant existed in fear of entering the spinal canal astray through spinal bifida gap resulting neural elements injury in spinal canal.After satisfied operation area exposure,club-shaped L5 spinal process was transected into two parts (proximal and distal) at L5-S1 interlaminar level,interlaminar decompression was then done,and intervertebral fusion cages were then inserted as traditional routine manipulation following other routine manipulations.No spinal dura sac leakage or other complications occurred intraoperatively and postoperatively.Excellent postoperative recovery obtained.%本文探讨一例L5杵状棘突并L5-S1椎间盘突出患者行椎间盘摘除,360度融合的操作技巧.患者为1名43岁男性,采取常规后正中入路,先对解剖结构正常的L5椎板区域行软组织剥离,然后再向骶椎隐裂的S1椎板部位暴露,避免误入S1隐裂区内损伤椎管内结构.完成术野暴露后,将杵状棘突在L5-S1椎板间隙平面切断,完成椎板间大开窗减压,最后顺利完成椎体间cage植入及其它操作.患者未发生脑脊液漏等并发症,手术效果良好.
展开▼
