后路选择性减压RF器械复位内固定椎体间植骨融合治疗腰椎滑脱症  

Tteatment of lumbar spondylolisthesis with posterior RF fixation and interbody fusion

作　　者：张怀成[1] 李程[1] 王太平[1] 汪亚力 罗勇[1] 黄河[1] 范国富[1] 谢瑞莲[1] 

机构地区：[1]四川省内江市第三人民医院骨科,641000

出　　处：《中国脊柱脊髓杂志》2008年第2期108-110,共3页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:探讨后路选择性减压RF器械复位内固定椎体间足量打压植骨融合治疗腰椎滑脱症的效果。方法:1998年9月～2006年6月共收治腰椎滑脱症患者86例,均采用后路选择性减压(开窗或半椎板切除)、RF器械复位固定、椎间足量打压植骨融合术治疗。术后随访观察椎体间植骨融合情况及临床效果,根据侯树勋等的疗效评定标准及Suk等的植骨融合评定标准进行评价。结果:无切口感染及神经根损伤患者,切口脂肪液化3例,经换药伤口愈合;3例术中神经根袖破裂,术后发生脑脊液漏,观察3～5d夹闭引流管见脑脊液漏停止后拔管,经换药引流口愈合。随访1～8年,平均3.6年,术后1～2周X线片复查示复位不良3例,其中1例再次手术矫正,2例姑息治疗结果融合失败,其余患者均获植骨融合,椎体间植骨融合率97.67%,临床疗效优良率96.5%。结论:经后路选择性减压RF器械复位内固定椎体间足量打压植骨治疗腰椎滑脱症手术操作简单,损伤小,骨性融合率高,并发症少。Objective：To investigate the results of lumbar spondylolisthesis treated with selective posterior decompression,RF instrumentation reduction and fixation,and interbody fusion with adequate compressed bone graft.Method：From September 1998 to June 2006,86 cases of lumbar spondylolisthesis underwent selective posterior decompression （fenestration or semi-laminectomy）,RF instrumentation reduction and fixation,adequate compressed fusion.Follow-up observations included the outcomes of interbody fusion and clinical effect,the outcomes were evaluated according to HOU Shuxun＇s and other assessing standards about interbody fusion and clinical effect.Result：There was no incision infection and nerve root injury,three cases had incision fat liquefaction,which were cured by dressing wound,their were three cases of cerebrospinal fluid leakage caused by nerve root sleeve rupture,extubation was performed after 3-5 days and cerebrospinal fluid leakage stopped,the drainage orifice was healed by dressing change.Follow-up time ranged from 1 to 8 years,with an average of 3.6 years.All were examed by X-rays at one or two weeks after operation,three cases showed poor reduction,one was re-corrected,other two were treated by conserved method,which resulted in fusion failure. The rate of interbody fusion was 97.67% ,the rate of excellent or good clinical efficacy was 96.5%.Conclusion：This kind of technique is a simple,safe and mini-invasive therapeutic method,with high bony fusion rate and less complications.

关 键 词：脊椎滑脱症 腰椎 脊柱融合术 

分 类 号：R681.5[医药卫生—骨科学]