退变性腰椎滑脱症的手术治疗策略  

Surgical treatment of degenerative lumbar spondylolisthesis

作　　者：周雪峰[1] 马华松[1] 邹德威[1] 白克文[1] 彭军[1] 鲍磊[1] 宋志[1] 姬勇[1] 赵昌松[1] 

机构地区：[1]解放军第306医院全军脊柱外科中心,北京市100101

出　　处：《总装备部医学学报》2008年第3期132-134,187,共4页Medical Journal of General Equipment Headquarters

摘　　要：目的探讨后路腰椎神经根管减压、滑脱复位、椎间植骨融合术治疗退变性腰椎滑脱症的效果。方法应用PLIF(posterior lumbar interbody fusion)技术进行神经根管减压、钉棒系统复位固定和椎间植骨融合手术治疗退变性腰椎滑脱36例,其中单节段滑脱28例、双节段滑脱8例。结果所有病例随访1年以上,原有的神经压迫症状消失,其中间歇性跛行28例、下肢放射痛24例均消失,有8例遗留慢性腰痛,其疼痛程度较术前减轻。无早期并发症发生。术后X线片复查显示椎间高度均得到不同程度的恢复,有1例术后15个月出现融合器下沉,1例出现植骨块吸收。结论后路腰椎神经根管减压、滑脱复位、椎间植骨融合治疗退变性腰椎滑脱效果满意,正确安全彻底的神经根管减压是取得满意临床效果的关键。Objective To investigate the therapeutic effect of posterior lumbar spinal nerve canal decompression,reduction and fixation with interbody fusion on degenerative lumbar spondylolisthesis.Methods 36 patients with degenerative lumbar spondylolisthesis were underwent posterior lumbar spinal nerve canal decompression,reduction and fixation with interbody fusion.Results All cases were followed up for more than one year.Neural compression symptoms were relieved,including 28 cases of intermittent claudication and 24 cases of lower limb radiant pain.Chronic lower back pain was diminished in 8 cases,and lighter than before operation.No early complications were noticed.Postoperative radiography showed that the height of intervertebral space was restored in some degree.15 months after operation,one cage sinking was noticed in one case,and the bone graft absorption was found in another case.Conclusion Posterior lumbar spinal nerve canal decompression,reduction and fixation with interbody fusion is an effective technique in the treatment of degenerative lumbar spondylolisthesis,in which the correct and complete decompression is a key point for satisfactory clinical results.

关 键 词：退变性腰椎滑脱 神经根管减压 椎间植骨融合 

分 类 号：R687.3[医药卫生—骨科学]