Preliminary clinic application of artificial lumbar disc replacement under laparoscope

English Keywords:Artificial disc replacement  Lumbar  Laparoscope

English Abstract:

  【Abstract】 Objective：To study the feasibility of clinic application of artificial lumbar disc replacement under laparoscope.Method：12 cases who underwent artificial lumbar disc replacement under laparoscope from March 2009 to May 2010 were reviewed retrospectively，including 8 males and 4 females with an average age of 46.6 years（range，42 to 56 years）.9 cases presented with discogenic low back pain and 3 cases with lumbar disc herniation.L4/5 segment was involved in 7 cases and L5/S1 in 5 cases.All patients underwent conservative treatment for at least 6 months，but did not respond.All patients underwent three-dimensional computed tomographic angiography（3D-CTA） for blood vessels in front of the lower lumbar prior to operation.The anteroposterior， lateral and dynamic X-ray was performed 3 days，1 month，3 months and 1 year after operation respectively.Result：All laparoscopic operations were completed successfully.The mean operation time was 136min（range， 90-180min） and the mean intraoperative blood loss was 120ml（range，80-360ml）.There was no injury to the major vessels，ureteral and abdominal viscera.All patients had low back pain relieved.The mean follow-up was 33 weeks（range，5-64 weeks）.No instrument failure except one prosthesis malposition.5 cases with follow-up of more than 1 year had the mean range of motion（ROM） of 8.2°（range，7°-9°）.Conclusion：It is feasible to perform artificial lumbar disc replacement（L4/5 and L5/S1） under laparoscope based on the techniques of laparoscopy and open surgery.