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腰椎后外侧植骨融合术，是在腰椎横突、小关节周围进行植骨。手术不经椎管，不易损伤神经。因局部血管丰富，植骨容易愈合。  警告：请在有WIFI的场所观看视频，土豪请随意。
Posterolateral Gutter Fusion Surgery 脊柱后外侧融合术 Any type of spine fusion joins together, or fuses, a spinal segment to eliminate the motion at that level of the spine. 任何类型的脊柱融合术，都是将脊柱节段连接到一起，即融合起来，以消除这一节段脊柱的运动。 A lumbar posterolateral gutter fusion is done in the lower back — at L1 through L2, through L5 through S1 at the bottom of the spine. It is most commonly done at L4 through L5 or L5 through S1, as these are the segments most likely to degenerate. 腰椎后外侧融合术是在腰椎，即从腰1/2到脊柱底端的腰5/骶1节段进行手术。最常做的是腰4/5或腰5/骶1，因为这两个节段最容易退变。 The surgery involves placing a bone graft in the posterolateral portion of the back of the spine. 手术涉及在脊柱后方的后外侧部位放置骨移植物。 The procedure begins with a 3-to-6 inch long incision in the midline of the back. The back muscles surrounding the spine are then retracted to the side. 手术首先在背部正中作一个3~6英寸的切口。然后将脊柱背侧周围的肌肉向两侧牵开。 If needed, the surgeon may also perform a laminectomy along with the fusion, to remove arthritic bone or other material putting pressure on the spinal nerves. 如果有必要，术者会在融合的同时作椎板切除术，以去除有关节炎的骨头和其它压迫脊神经的组织。 Bone graft is retrieved from the iliac crest, the uppermost portion of the back of the pelvis. Most surgeons use the same incision for retrieving the bone graft and for the fusion. Synthetic or cadaver bone graft may also be used. 骨移植物取自骨盆后方最高处的髂嵴。很多外科医生在同一切口内取植骨材料用于融合。有时也可以使用人工骨或异体骨。 The back muscles that attach to the transverse processes are then lifted up, exposing the posterolateral area and creating a bed for the bone graft. 然后将附着于横突的背部肌肉剥开，显露后外侧区域，准备植骨床。 The posterolateral area is used because it has a high concentration of blood vessels that help the body generate the new tissue needed to create the bone fusion. 使用后外侧区域是因为这里血管丰富，有利于新的组织生长，促进骨融合。 The bone graft morsels are laid out on the exposed posterolateral area. 将骨移植物颗粒平铺于显露好的后外侧区域。 The surgeon then moves the muscles back down over the graft, generating tension that will hold it in place as the body heals. 然后，术者将肌肉回放，覆盖于移植物表面，产生的张力能在身体愈合的时候保持移植物在位。 The process is repeated on the other side of the spine so that both sides can fuse. 在对侧重复上述步骤，这样两侧都能融合。 The surgeon may also use spinal instrumentation, such as pedicle screws and rods, to provide additional stability while the bone fusion is healing together. 术者也可能使用脊柱内固定材料，比如椎弓根螺钉和棒，以便在骨融合过程中提供额外的稳定性。 Over the next several months, the body's natural healing response will help the bone graft and adjacent vertebral bodies fuse into a single bone. 在今后数月，人体的自愈机制会帮助骨移植物与相邻的椎体融合成一个整体。 （高晨珉 转） |
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