抄録
Interbody fusion from an anterior/posterior approach should be chosen as the surgical treatment for degenerative lumbar disease with anterior column deficiency. The new technique called Cantilever Transforaminal Interbody Fusion is an effective and safe fusion procedure for degenerative lumbar disease. 21 men and 16 women had this surgery. The mean age at surgery was 60 years. Diagnoses were, degenerative spondylolisthesis (22 cases), recurrent herniated disc (3 cases), lateral stenosis (3 cases), spinal stenosis (3 cases), degenerative scoliosis (2 cases), degenerative disc disease (2 cases), spondylolytic listhesis (1 case), and herniated disc (1 case). The mean follow-up period was 20 months. The mean operation time was 259 min. The mean blood loss was 471 ml. Local and artificial bone was used for the bone graft in 6 cases, local and iliac crest bone in 14 cases, and only local bone in 17 cases. The JOA score increased from 12.3 to 24.1 out of 29 points at the latest follow-up. In the conventional PLIF procedure, the surgeon must retract the dural sheath out to the midline. In the TLIF technique, the path to the disc runs diagonally to the vertebral foramen, reducing the risk of neural damage from retraction. The Cantilever technique with IBS restores lordosis, and puts compressive loading on the bone graft, which enhances the likelihood of fusion.
