▲Due to the special design of the equipment for minimally invasive surgery, the surgical wound is smaller, the postoperative wound pain is reduced, and the number of hospitalization days is reduced, allowing the patient to recover quickly.
(Photo courtesy / Wang Haojing)
Text/Wang Haoyu
Lumbar fusion has been developed for more than 70 years. However, it was not until the 1990s that lumbar intervertebral disc implants were developed to support and stabilize the intervertebral disc space. It has been used as a standard option for the treatment of spinal instability, spinal stenosis, spondylolisthesis, and scoliosis. Taiwan has also significantly increased the proportion of lumbar fusion surgery in the past 20 years.
However, the lumbar fusion developed in the 1990s is usually performed after posterior decompression. Lumbar intervertebral fusion requires the pulling of the nerve root to obtain sufficient access for the intervertebral disc implant to enter the posterior intervertebral disc space. This increases the risk of nerve root damage.
In addition, traditional fusion surgery has a large wound, about 10-15 cm. After surgery, there are often problems with adhesion of the epidural scar tissue or degeneration of adjacent segments. This often leads to the need for re-operation.
Minimally invasive lumbar fusion is to enter the intervertebral disc space through the intervertebral foramina approach. The new technology can reduce the pulling of nerve roots by removing small joints, reduce the risk of duratomy, and limit possible nerve damage. The contralateral lamina and spinous process can also be retained, so that the problem of the adhesion of the epidural scar tissue or the degeneration of adjacent segments is reduced. The most important thing is that because minimally invasive surgery has smaller wounds, blood loss is greatly reduced, postoperative wound pain is reduced, and the number of hospitalization days is reduced, allowing patients to recover quickly.
Taiwan currently only uses 20%
Minimally invasive lumbar fusion surgery has reached about 80% in the United States, but it is still only 20% in Taiwan. In order to reduce the overall complications in the future, patients may need to consider performing minimally invasive lumbar fusion.
(The author is Associate Professor of Yishou University, Director of Neurosurgery of Eida Hospital)
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