intertransverse fusion

It is often used in patients with postoperative pseudoarthrosis, laminar defect and lumbar spondylolisthesis. It is also used in patients with pain caused by instability after laminectomy. Mostly used for the lumbar spine. Treatment of diseases: lumbar spondylolisthesis Indication 1. Due to joint trauma, inflammation, degeneration, etc., the joint surface is disproportionate, causing severe joint dysfunction, or stubborn joint pain, affecting work and life, non-surgical treatment is invalid, and other surgery is not suitable. To maintain joint mobility, joint fusion should be performed. For example, severe arthritis caused by intra-articular fractures of the lower extremities, and there are a large number of scars in the surrounding soft tissue after septic arthritis, and it is not suitable for surgery such as arthroplasty. 2. Adult all-tubular tuberculosis, joint surface destruction, it is estimated that the joint function can not be preserved, joint fusion can be performed at the same time as the lesion is removed; and there are deformities, which can correct the deformity at the same time. 3. Muscle spasm caused by neuropathy or injury, causing severe instability of the joint, affecting the whole limb function, and simple tendon metastasis is not enough to maintain joint stability and restore sufficient effective function. Fixing local joint can improve limb function. Perform joint fusion. For example, after the anterior horn polio of the spinal cord, the upper limbs can not be lifted. If the shoulder joint is fixed in the functional position, the function of the upper limb can be improved by sliding the shoulder between the shoulders. 4. Congenital or acquired spinal deformity (such as hemivertebra, scoliosis, lumbar spondylolisthesis, etc.), in order to prevent the development of deformity, early laminectomy can be performed, or after deformity correction. Contraindications In addition to the general contraindications for elective surgery, the following conditions should also be contraindicated: 1. Patients with osteoarthritis adjacent to the joint should not be used for arthrodesis. If the hip joint is fused, its activity can be compensated by the normal lumbar spine and knee joint to meet the needs of work and life activities. If the lower lumbar or knee joint is already stiff, hip fusion will cause great difficulty to the patient. 2. Among the same joints of the limbs, one side has a strong straight, and the contralateral side should not be subjected to arthrodesis. If the hip joints are fused on both sides, it will be very difficult to get up, lie, walk and sit. 3. Children's articular cartilage is rich, joint fusion is not easy to cause bone fusion, but also easy to damage the epiphysis, affecting growth and development; at the same time, children in the limb development stage and muscle sustained action, the fusion joint can be deformed again. Therefore, children under the age of 12 should not undergo arthrodesis. Surgical procedure 1. Position: prone position. 2. Incision: longitudinal incision along the outer edge of the sacral spine muscle, the lower end curved to the posterior superior iliac spine, the length depends on the fusion transverse process. A median incision can also be used, taking into account both lateral transverse processes. 3. Exposure: cut the skin, the back fascia, separate and pull along the outer edge of the sacral spine muscle, the deep can touch the transverse process, cut the periosteum along its longitudinal axis, separate the muscles and ligaments attached thereto; Open the sacral spine muscles, separate to the sides, reveal the transverse process of the transverse process and joints, and stop the bleeding. If the lumbosacral joint is fused, the back of the humerus should be revealed. 4. Bone graft fusion: the transverse process, the articular process or the humerus of the humerus need to be chiseled, and the large skeleton is placed on the bone, and the cancellous bone is planted around it. Then compact. The joint capsule and cartilage surface between the joints should be removed when needed. The bone graft was taken from the tibia of the incision.

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