On June 10, 2024, at Alty Orthopaedic Hospital in Kuala Lumpur, Malaysia, Dr. Wong Chung Chek, Dr. Lee Chee Kean, and Dr. Lim Sze Wei collaborated on Malaysia’s first Lumbar Artificial Disc Replacement surgery in nearly 20 years. They successfully replaced the patient’s L4/L5 and L5/S1 lumbar discs with lumbar artificial discs. The surgery was highly successful.

2024年 6月 10日，在马来西亚吉隆坡的 Alty骨科医院，黄宗杰医生、李志坚医生和林诗伟医生合作进行了马来西亚20年来首例腰椎人工椎间盘置换术。他们成功地为病人的L4/L5和L5/S1椎间盘进行了人工椎间盘置换。手术非常成功。

Lumbar Artificial disc replacement surgery | 腰椎人工椎间盘置换术

Lumbar artificial disc replacement surgery is a surgical procedure used to treat degenerative lumbar disc disease. By removing the damaged disc and replacing it with an artificial one, the surgery helps relieve pain and restore disc function. The primary goal is to treat lower back pain. The procedure involves accessing the disc through an extraperitoneal incision, removing the damaged disc, and implanting an artificial disc, typically made of metal and polymer materials.

The key advantage of this surgery is that it preserves the patient’s spinal range of motion and reduces the risk of adjacent disc degeneration. It is recommended for patients with degenerative lumbar disc disease who have not responded to conservative treatment.

腰椎人工椎间盘置换术（以下简称为腰椎间盘置换术）是一种治疗腰椎间盘退行性疾病的手术。通过移除损坏的椎间盘并置换人工椎间盘，缓解疼痛并恢复椎间盘功能，手术 主要目的是治疗腰痛，手术过程从腹膜外切口进入椎间盘去移除受损椎间盘，然后植入人工椎间盘（普遍为金属和聚合物材料）。此手术的优势是病患得以保留脊柱活动范围，减少相邻椎间盘退变风险，此手术适用于保守治疗无效的腰椎退行性疾病患者。

PROCEDURE FLOW | 手术流程

First, identify and mark the midline on the adjacent upper and lower vertebral bodies near the surgical site. Next, perform a sufficiently wide disc incision along the midline to accommodate the implant. Thoroughly remove the disc using a bone chisel, standard nucleus forceps, Kerrison rongeur, and curette, ensuring that no disc material remains in the posterolateral corners.

Once completed, remove the chisel and trial implant. Align the keel of the implant with the chisel incision and insert the endplates into the posterior edge of the vertebral bodies. Then, place the polyethylene insert into the groove of the lower arm of the inserter. Assemble the distractor with the inserter and fully advance the distractor using the thumb screw. Afterward, confirm that the posterior edges of the endplates are separated. Finally, insert the pusher into the groove of the lower arm and manually advance and lock the polyethylene insert into the lower endplate.

首先，在与手术区域相邻的上、下椎体上识别并标记中线。其次，在中线上进行足够宽的椎间盘切开术以容纳植入物。使用骨撬、标准的髓核钳、Kerrison剪刀和刮匙进行彻底的椎间盘切除，确保后外侧角没有椎间盘材料残留。完成后，取出凿子和试验植入物。将植入物的龙骨与凿子切口对齐，并将端板插入椎体的后缘，然后将聚乙烯嵌件装入插入器下臂的凹槽中。将扩张器与插入器组装在一起，并用拇指螺钉完全推进扩张器。完成后，确认端板的后缘彼此分离。将嵌件推入器插入下臂的凹槽中，然后手动推入并锁定聚乙烯嵌件到下端板中。