Minimally Invasive Spinal Fusion
What is minimally invasive spinal fusion?
脊柱融合术是一种将2块或更多的脊柱骨永久连接在一起的外科手术. 微创脊柱融合术使用比传统脊柱融合术更小的切口.
Your vertebrae are the small bones that make up your spinal column. 这些椎骨彼此堆叠在一起，由椎间盘分开. These bones protect your delicate spinal cord, 哪一个将信息从大脑发送和接收到身体的其他部位.
各种各样的身体状况可能会导致你的椎骨过度地相互对抗. 这会拉伸周围的神经、韧带和肌肉，引起疼痛. For example, if you have arthritis of your spine, your vertebrae might hurt when they move against each other. 脊柱融合术可以通过阻止一个或多个椎骨移动来缓解疼痛.
根据你的问题，你的外科医生可能会使用不同的方法到达你的椎骨. For example, with direct lateral interbody fusion, your surgeon accesses your vertebrae from your side. 在椎间孔腰椎椎间融合术中，你的外科医生通过你的背部接近你的脊柱. 然后，你的外科医生会在你的椎骨之间植入某种移植物(比如骨头).
For minimally invasive spinal fusion, you’ll be given medicine (general anesthesia) to put you asleep. A small incision will be made to access your spine. 你的外科医生会用一种特殊的工具轻轻推开你背部的肌肉. Your surgeon will then weld together 2 or more of your vertebrae, using bone or some other artificial material.
微创脊柱融合术使用比传统手术更小的切口. It also doesn’t cut away the muscles of your spine. 正因为如此，它可能会比传统手术更快地恢复. It may also reduce the chance for certain problems.
Why might I need minimally invasive spinal fusion?
你可能需要脊柱融合术来治疗各种疾病，包括:
- Degenerative disc disease
- Spinal stenosis
- Spondylolisthesis
- Scoliosis
- Break (fracture) of your spinal column
- Infection of your spinal column
- Tumor in your spinal column
These conditions might be causing you significant back pain. 你的医疗保健提供者可能会先尝试其他更保守的治疗方法, such as pain medicines and physical therapy. 如果这些对你不起作用，微创脊柱融合术可能是有意义的. But spinal fusion can’t help all types of back pain. 只有在手术对你有效的情况下，你的医疗保健提供者才会建议你这样做.
与您的医疗保健提供者讨论微创脊柱融合术的风险和益处, instead of a traditional one.
Spine Surgery Q&A with Hamid Hassanzadeh, M.D.
What are the risks of minimally invasive spinal fusion?
大多数人的微创脊柱融合术效果都很好. But as with any surgery, the procedure does carry some risks. Possible complications of minimally invasive spinal fusion include:
- Infection
- Too much bleeding
- Lack of a solid bone fusion
- Nerve damage
- Blood clots
还有一个风险是，你的手术不能有效地消除你的疼痛, 或者手术可能会在移植部位引起另一种类型的持续疼痛.
所有脊柱融合手术的一个副作用是脊柱的柔韧性降低. 通常，这只限制了运动的一小部分，并不是一个大问题.
Your own risk for complications may vary according to your age, the surgical approach, the anatomy of your back problem, and your other medical conditions. 向您的医疗保健提供者询问最适合您的风险.
How do I get ready for minimally invasive spinal fusion?
询问你的医疗保健提供者你应该如何准备你的手术. 询问是否应该提前停止服用任何药物，比如血液稀释剂. If you are a smoker, you should try to quit before your surgery. 在手术前的午夜之后，你需要避免进食或饮水. 您的医疗保健提供者可能会在手术前要求对您的脊柱进行额外的成像, such as an MRI.
What happens during minimally invasive spinal fusion?
您的医疗保健提供者可以帮助解释您的特定手术的细节. 这取决于你受伤的性质和手术方式. 一名整形外科医生和一组专业护士将进行手术. The whole surgery may take a couple of hours. In general, you can expect the following:
- 你会被麻醉，这样你就会睡着，在手术过程中不会感到任何疼痛或不适.
- Your vital signs, like your heart rate and blood pressure, will be carefully watched during the surgery. 在手术过程中，你可能会在喉咙里插入一根呼吸管来帮助你呼吸.
- 在手术过程中和手术后，你可能会被给予抗生素，以帮助预防感染.
- 你的外科医生会做一个小切口，通常在你的侧面或背部.
- 使用特殊的工具，他或她会扩张你的背部肌肉，把它们推开.
- 你的外科医生会移除你患椎骨之间的椎间盘.
- 他或她会在你的椎骨之间放置某种物质. This might be bone or a synthetic bone-like material.
- 你的外科医生可能会使用特殊的螺钉或其他材料来固定你的骨头.
- Your surgeon will make other repairs, if needed.
- The layers of skin around your incision will be surgically closed.
What happens after minimally invasive spinal fusion?
和你的医疗保健提供者谈谈手术后你可以期待什么. You may have some pain around your incision after the procedure, but you can take pain medicines to relieve it. 你应该能很快恢复正常的饮食和活动. 你可能会做一些成像程序，比如x光，来看看你的手术进行得如何. 取决于你受伤的程度和其他医疗条件, you might be able to go home within the next couple of days.
你最初的症状可能会在手术后立即大大减轻, or they might go away more slowly.
Follow all your healthcare provider’s instructions carefully. 他或她可能不希望你服用某些非处方止痛药. Some of these can interfere with bone healing. 你的医疗保健提供者可能会建议你吃高钙和维生素D的饮食，因为你的骨骼愈合.
You might have a little drainage from your incision. This is normal. 如果你发现红肿加重，马上让你的医疗保健提供者知道, swelling, or draining from your incision. 你也应该让他或她知道，如果你有高烧或严重的疼痛，没有改善. Make sure to keep all of your follow-up appointments. 你可能需要在手术后一周左右拆线.
当你愈合的时候，重要的是要保持你的脊椎在正确的方向上. A healthcare provider will show you the proper way to move. 一开始，你可能只需要做一些轻微的活动，比如散步. As you heal, you’ll be able to slowly increase your activity level.
Next steps
Before you agree to the test or the procedure make sure you know:
- The name of the test or procedure
- The reason you are having the test or procedure
- What results to expect and what they mean
- The risks and benefits of the test or procedure
- What the possible side effects or complications are
- When and where you are to have the test or procedure
- 谁来做测试或程序，那个人的资格是什么
- What would happen if you did not have the test or procedure
- Any alternative tests or procedures to think about
- When and how will you get the results
- 在测试或程序后，如果您有疑问或问题，可以打电话给谁
- How much will you have to pay for the test or procedure
