单侧经椎间孔腰椎间融合治疗腰椎节段性不稳  

Treatment of Lumbar Segment Instability with Unilateral Transforaminal Lumbar Interbody Fusion

作　　者：占蓓蕾[1] 徐德洪[1] 何飞熊[1] 叶舟[1] 

机构地区：[1]浙江省衢州市人民医院骨科,浙江衢州324000

出　　处：《实用骨科杂志》2006年第2期100-102,共3页Journal of Practical Orthopaedics

摘　　要：目的探讨单侧经椎间孔后路腰椎间融合与内固定治疗腰椎不稳的临床疗效。方法本组采用单侧经椎间孔后路椎间融合与TENOR脊柱内固定系统治疗腰椎节段性不稳32例，49个节段，其中腰椎退行性滑脱7例，节段不稳伴椎管狭窄16例，节段不稳伴椎间盘突出9例。结果经6～22个月，平均12个月的随访，2个月融合节段可见模糊骨痂生长，4～6个月达骨性愈合，术后症状消失25例，显著改善5例，优良率为93％。无固定螺钉松动、断裂，无椎间高度及复位丢失情况，钛网融合器除1例放置偏后并有2mm下沉外，其余均正常。结论单侧经椎间孔腰椎间融合术是新近发展应用的技术，与后路椎弓根螺钉系统联合应用，可使腰椎获得即刻稳定，恢复脊柱序列及椎间高度，维持腰椎生理弧度，促进植骨融合。Objective To evaluate the clinical treatment effects to lumbar segment instability by posterior unilateral transforaminal lumbar interbody fusion（TLIF） and internal fixation. Methods 32 cases （49 segments） with lumbar segment instability were treated by posterior unilateral TLIF and TENOR fixation, including 7 cases with spondylolisthesis, 16 cases with unstable lumbar stenosis and 9 cases with unstable disc herniation. Results All cases were followed-up from 6 to 22 months with an average time of 12 months. Vague callus were presented 2 months postoperatively and bony fusions were observed 4-6 months after operation. The clinical symptoms were relieved in 25 cases, improved significantly in 5 cases, with an excellent rate of 93%. No loosening and breaking screws, no loss of height and reduction were found except the titanium mesh subsidence 2 mm and posterior incline in one case. Conclusion TLIF is a new technique. Combined with posterior pedicle screw fixation system, it can obtain lumbar stability immediately, recover spinal sequence and height and promote graft body fusion.

关 键 词：腰椎不稳 经椎间孔 椎间融合 钛网融合器 内固定 

分 类 号：R681.55[医药卫生—骨科学]