椎弓根螺钉固定并椎体间植骨治疗腰椎滑脱症  

Clinical Analysis of Treatment of Lumbar Spondylolisthesis by Screw to Predicle of Vertebral Arch Fixation

作　　者：文朝[1] 潘会琴 吴建斌[1] 方楚权 王新[1] 熊卜贵 

机构地区：[1]深圳市龙岗区横岗人民医院骨科,广东深圳518000

出　　处：《实用骨科杂志》2009年第8期572-574,共3页Journal of Practical Orthopaedics

摘　　要：目的评价经后路椎弓根钉内固定并腰椎椎体间植骨融合术治疗腰椎滑脱的临床疗效。方法本组采用后路椎弓根螺钉将滑脱椎体提拉复位,椎板减压,自体髂骨椎间植骨融合治疗腰椎滑脱症38例。从滑脱复位结果、融合的成功率、术前术后进行视觉疼痛评分、弯腰功能评分以及并发症等方面进行评价。结果38例患者平均随访1年6个月。滑脱距离由术前(36.45±15.12)%恢复至术后的(8.24±4.11)%,(P<0.05)。全部病例均获得融合,融合率100%。术前视觉疼痛评分和弯腰功能评分分别是(6.3±2.6)分和(23.6±15.4)分,术后随访时为(2.4±1.6)分(P<0.01)和(48.2±19.2)分(P<0.01),38例患者中35例手术效果优良,优良率为92.11%。并发症共3例,1例术后出现脑脊液漏,2例术后出现单侧沿坐骨神经根性放射痛,术后2周症状消失,未出现椎弓根螺钉松动或断裂,无神经损伤等并发症。结论本组采用椎管减压,椎体复位,椎弓根钉内固定并自体髂骨椎间植骨融合治疗腰椎滑脱,具有复位率、融合率高,疗效确切的特点,减少了腰椎术后综合征的发生率。Objective Evaluating the clinical effect of treating lumbar spondylolisthesis via posterior transpedicular instrumentation and PLIF. Methods This unit applying to repositing olistby vertebral body by posterior prediele of vertebral arch screw,vertebral lamina decompression,auto lilac bone intervertebral bone grafting to treat lumbar spondylolistbesis ,all together 38 cases. The evaluation was based on the results of olisthy olisthe reposition,the success rate of fusion,scorning of visual pain of the operation before and afterward,scorning of LBO and complication, ect. Results 3 8 cases ： average visiting time 1 year and 6 months . The olisthy distance reduced from （ 36.45±15.12）% （before operation） to （8.24±4.11 ）%, （P〈0. 05） after operation. All of them are fused;the fusion rate is 100G. The average scorning of VAS and LBOS are 6. 3±2. 6 and 23. 6±15.4, but after operation,random check shows 2.4±1.6（P〈0.01） and 48.2±19.2（P%0.01）. In the 38 patients,excellent is 35 and it occupies 92, 11%, complication is 3,1 occurs CSF leak after operation, 2 occur unilateral sciatic nerve root radiating pain and the symptom disappear 2 weeks later. No predicle of vertebral arch screw loosing or breaking,no nerve injury complication occur. Conclusion This unit applies vertebral lamina decompression,vertebral body reposition,posterior transpadicular instrumentation and auto iliac bone intervertebral bone grafting to treat lumbar spondylolisthesis which has the features of high rate of reposition,high fusion rate ,definite curative effect and reduces the eomplicatiota rate after lumbar operation.

关 键 词：腰椎滑脱 椎弓根钉内固定 髂骨植骨术 椎间融合术 

分 类 号：R681.57[医药卫生—骨科学]