GSS型椎弓根螺钉系统加椎间自体髂骨植骨融合治疗腰椎滑脱症  

GSS pedicle screw system and interbody autogenous iliac bone graft fusion in the treatment of lumbar spondylolisthesis

作　　者：申练兵[1] 陈其昕[1] 

机构地区：[1]浙江大学医学院附属第二医院脊柱外科,杭州310009

出　　处：《中国医师进修杂志》2013年第5期8-10,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的观察GSS型椎弓根螺钉系统后路复位内固定加椎间自体髂骨植骨融合治疗腰椎滑脱症的临床效果。方法采用GSS型椎弓根螺钉内固定系统加椎间自体髂骨植骨融合治疗腰椎滑脱症21例，随访分析临床疗效、滑脱率、复位率、椎间融合情况及椎间隙高度变化。结果21例患者术后滑脱率、复位率与术前比较差异有统计学意义[（6．41±6．90）％比（36．75±7．11）％，（86．75±24．40）％比0]（q=19．60、19．72，P〈0．01）；随访时滑脱率、复位率与术后比较差异无统计学意义（q=0．70、0．96，P〉0．05）。术后椎间隙高度与术前比较均显著改善[L4-5，椎间隙：（7．6±1．3）mm比（5．2±0．8）mm；L5S1椎间隙：（8．4±2．2）mmIzL（6．5±1．5）mm]（q=6．64、3．83，P〈0．01）；随访时椎间隙高度与术后比较差异无统计学意义（q=2．48、2．42，P〉0．05）。所有患者均骨性融合，融合率100．00％（21／21）。术后6个月、术后1年、术后2年JOA评分与术前比较差异均有统计学意义[（20．50±3．83）、（23．58±3．60）、（24．91±2．90）分比（9．67±4．45）分]（F=71．92，q=13．28、17．06、18．69，P〈0．01）。无内固定断裂或松动等并发症。结论GSS型椎弓根螺钉后路复位内固定系统加椎间自体髂骨植骨融合治疗腰椎滑脱症的临床疗效满意，椎间自体髂骨植骨具有植骨面积及植骨量大、骨融合率高等优点，是手术治疗腰椎滑脱症较好的方法之一。Objective To observe the clinical effect of GSS pedicle screw system and interbody autogenous iliac bone graft fusion in the treatment of lumbar spondylolisthesis. Methods Twenty-one lumbar spondylolisthesis patients was treated by GSS pedicle screw system and interbody autogenous iliac bone graft fusion. Followed up and analyzed the clinical therapeutic efficacy, rate of detachment and reduction, interbody fusion and intervertebral height change. Results Postoperative rate of detachment and reduction had significant difference compared with preoperative [（6.41 ± 6.90）% vs. （36.75 ± 7.11 ）%, （86.75 ± 24.40）% vs. 0 ] （q = 19.60,19.72, P 〈 0.01 ）. Final follow-up rate of detachment and reduction had no significant difference compared with postoperative （q = 0.70,0.96, P 〉 0.05 ）. Postoperative intervertebral height had significant difference compared with preoperative[ L4-5： （7.6 ± 1.3 ） mm vs. （5.2 ± 0.8 ） mm; L5S1 ： （8.4 ± 2.2） mm vs. （6.5 ± 1.5） mm]（q = 6.64,3.83,P〈 0.01 ）. Final follow-up intervertebral height had no significant difference compared with postoperative （q = 2.48,2.42, P 〉 0.05 ）. All patients were bony tusion, rate of fusion was 100.00%（21/21 ）. In accordance with the Japan institute of orthopaedics （JOA） low back pain surgery standards, the scores of 6 months, 1 year, 2 years significant increased compared with preoperative [ （20.50 ± 3.83）, （23.58 ± 3.60）, （24.91 ± 2.90） scores vs.（9.67 ±4.45） scores] （F= 71.92,q = 13.28,17.06,18.69,P 〈 0.01 ）. No complication of internal fixation for fracture or looseness. Conclusions The clinical effect of GSS pediele screw system and interbody autogenous iliac bone graft fusion in the treatment of lumbar spondylolisthesis is good. It has advantages of bone graft area and bone mass, rate of fusion. It is one of better methods in tbe treatment of lumbar spondylolisthesis.

关 键 词：脊椎前移 髂骨 脊柱融合术 自体 

分 类 号：R683.2[医药卫生—骨科学]