失稳者，能够复位至Ⅰ度以内的腰椎退变性滑脱或峡部不连所致滑脱者，腰椎节段不稳定需融合手术者，椎间盘源性腰痛需融合手术者，显著椎体后缘离断需要切除减压者，某些腰椎再次手术的病例。作者认为，根据加用后外侧融合的利弊权衡，对于多节段需要行椎体间融合者、椎体滑脱在Ⅲ度及以上者、椎管内严重狭窄需要全椎板切除的病例最好同时行PLF;对于单节段、单侧减压、术中后外侧结构仍有部分保留、椎体滑脱在Ⅱ度以下者可以考虑单纯PLIF术式。
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