改良后路椎间融合术治疗退行性腰椎滑脱  

Clinical efficacy of modified posterior lumbar interbody fusion on degenerative spondylolisthesis

作　　者：储惊蛰 储为民 崔志明[2] 徐管华[2] 金胡日查[2] 李得宝[2] 黄巍[2] 张金龙[2] 

机构地区：[1]岳西县医院骨科,安徽224600 [2]南通大学第二附属医院脊柱外科

出　　处：《脊柱外科杂志》2012年第3期134-138,共5页Journal of Spinal Surgery

摘　　要：目的探讨改良后路椎间融合术(posterior lumbar interbody fusion,PLIF)治疗退行性腰椎滑脱的临床效果。方法 2005年3月～2009年9月,82例退行性腰椎滑脱患者随机平均分成2组,分别使用改良PLIF术和传统PLIF术治疗。记录所有患者术前、术后疼痛视觉模拟量表(visual analogue scale,VAS)评分和日本骨科学会(JapaneseOrthopaedic Association,JOA)评分,并计算JOA改善率。结果术后随访12～54个月,平均27.5个月。改良PLIF组和传统PLIF组JOA评分术后3个月和末次随访与术前相比差异均有统计学意义(P<0.05),术后3个月与末次随访相比差异均无统计学意义(P>0.05)。2组VAS评分术后3个月和末次随访与术前相比差异均有统计学意义(P<0.05),术后3个月与末次随访相比差异均无统计学意义(P>0.05)。末次随访时2组JOA评分和VAS评分相比,差异均无统计学意义(P>0.05)。2组住院时间差异无统计学意义(P>0.05),而手术时间、术中出血量差异有统计学意义(P<0.05)。结论改良PLIF术治疗退行性腰椎滑脱可以获得与传统PLIF术相同的临床效果,且具有手术时间短、术中出血量少、组织损伤轻等优点。Objective To explore the clinical outcomes of modified posterior lumbar interbody fusion （PLIF） in the treat- ment of degenerative lumbar spondylolisthesis. Methods From Mareh 2005 to September 2009, 82 patients with degenerative lnnbar spondylolisthesis were randondy divided into 2 groups （n = 41 ） and treated with traditional PLIF and modified PLIF, respectively. Visual analogue scale （VAS） scores and Japanese Orthopaedie Association （JOA） scores were recorded before and after the treatment. Then the improvement rate of JOA score was ealenlated. Results The mean duration of follow-up was 27. 5 months （range, 12 to 54 months） for all the patients. In both modified PLIF group and the traditional PLIF group, JOA score was significantly increased and VAS score was signifieantly decreased at 3 months after surgery and at the final follow-up as com- pared with the score before surgery （P 〈 0. 05 ）. But there was no significant difference in VAS score between 3 months postoper- atively and the final foLlow-up in both groups （P 〉 0. 05 ）. Neither was the JOA score （P 〉 0. 05 ）. At the final follow-up, there was no significant differenee between the 2 groups in terms of JOA score and VAS score （P 〉 0. 05 ）. There were significant differences between the 2 groups in terms of operation time and blood loss （ P 〈 0.05 ）, but the postoperative hospital stay was not （ P 〉 0. 05 ）. Conclusion Functional outcome of modified PLIF is similar to traditional PLIF technique in the treatment of degenerative lumbar spondylolisthesis. But it has shorter operation time, and less blood loss and tissue damage.

关 键 词：腰椎 脊椎滑脱 脊柱融合术 

分 类 号：R681.533[医药卫生—骨科学]