棘突椎板原位回植并椎间植骨治疗峡部裂性腰椎滑脱  

Spinous Process-Vertebral plate in Situ Replantation and Intervertebral bone Graft to Cure Lumbar Spondylolysis

作　　者：王存平[1] 陈印明[1] 姜建军[1] 王本龙[1] 渠立振[1] 

机构地区：[1]山东省枣庄市立医院骨科,山东枣庄277100

出　　处：《河北医学》2009年第4期388-390,共3页Hebei Medicine

摘　　要：目的：探讨病椎棘突椎板原位回植,RF内固定,椎间植骨治疗峡部裂性腰椎滑脱的远期疗效。方法：2001年4月至2007年2月收治该病人68例资料齐全,棘突椎板整块取下,神经根管减压,RF内固定,椎间盘摘除,滑脱椎复位,椎间植骨,棘突椎板再原位回植。随访时观察病人的疗效,椎间是否融合,滑脱是否复发,测量术前、术后及随访时固定椎间隙的高度变化。结果：随访12-60个月,平均36个月。21例Ⅰ度滑脱与39例Ⅱ度滑脱术后全部解剖复位,8例Ⅲ度滑脱,有2例留有Ⅰ度滑脱,68例椎间完全融合,65例术后疼痛完全消失,有3例尚有不同程度的疼痛。结论：棘突椎板原位回植,重建椎管后部结构,可预防疤痕粘连压迫硬膜及神经根,预防术后复发,远期效果满意。Objective： To investigate the long - term effect of the spinous process - vertebral plate in situ replantation, RF fixation, intervertebral bone graft to cure lumbar spondylolysis. Method： Apr. 2001 to Feb. 2007, we calmed this kind of patients 68 cases, the spinous process laminectomy taken down enbloc, RF fixation, decompressed the nerve roots, dissectomy, lumbar spondylolysis reduction, interbody fusion, spinous process lamineetomy in situ replantation. We followed up the curative effect, the intervertebral whether fuses, slides whether recurs, and the height of the intervertebral space changes at the time of preoperative, postoperative and follow - up visit. Result： Follow - up 12 to 60 months, with an average of 32 months. 21 cases of lumbar spondylolysis Ⅰ °and 39 cases of lumbar spondylolysis Ⅱ° were anatomical reduction, 8 cases of lumbar spondylolysis Ⅲ° , left 2 cases of lumbar spondylolysis Ⅰ°, 68 cases interbody fusion completely, 65 cases preoperative pain completely disappeared, 3 cases remain varying degrees of pain. Conclusion： Spinous process ：laminectomy in situ replantation, reconstruction the Configuration of the posterior spinal canal, can prevent scarring and adhesion to oppressioning dura mate of spinal cord and nerve root , and can prevent reeurrenee as well, with long- term satisfactory results.

关 键 词：棘突椎板原位回植 椎间植骨 RF内固定 

分 类 号：R687.3[医药卫生—骨科学]