后路椎弓根钉复位固定加自体减压椎板骨粒超大量植骨治疗腰椎滑脱  

Posterior pedicle screw reduction and fixation, decompressive laminectomy and massive autogenous bone grafting for treatment of lumbar spondylolisthesis

作　　者：陈鹏[1] 朱国兴[1] 杨玉生[1] 陈刚[1] 石磊[1] 

机构地区：[1]无锡市第二人民医院骨科,214000

出　　处：《中华创伤杂志》2013年第8期753-755,共3页Chinese Journal of Trauma

摘　　要：目的探讨后路椎弓根螺钉复位固定加自体减压椎板骨粒超大量植骨治疗腰椎滑脱症的有效治疗方法。方法回顾性分析2005年6月-2010年6月收治的56例腰椎滑脱患者。根据Meyerding分类法：Ⅰ度滑脱35例，Ⅱ度滑脱21例。其中L4/5滑脱19例，L5-S1滑脱37例。采用后路椎弓根钉复位固定加自体减压椎板骨粒超大量植骨后，评价其手术疗效。结果所有患者植骨均融合，无断钉、损伤神经表现。根据Macrab评定标准评定：优53例，良3例。完全复位率及椎问融合率均达100％。结论后路椎弓根螺钉复位固定加自体减压椎板骨粒超大量植骨能够对滑脱的腰椎进行良好的固定、减压、复位和融合，是治疗腰椎滑脱症的理想方法之一。Objective To investigate the effect of posterior pedicle screw reduction and fixation, decompressive lamineetomy and massive autogenous bone grafting using bone particles harvested from resected vertebral body in treatment of lumbar spondylolisthesis. Methods Fifty-six cases of lumbar spondylolisthesis treated from June 2005 and June 2006 were reviewed retrospectively. According to Meyerding classification, 35 cases were classified as grade Islippage and 21 cases as grade Ⅱ slippage. There were 19 spondylolisthesis at L4/5 and 37 at L5-S1. After posterior pediele screw reduction and fixation, deeompressive laminectomy and massive autologous bone grafting using particles of resected vertebral body, surgical outcome was analyzed. Results All cases achieved bone fusion without evidence of nail breakage or nerve injury. According to Macrab criteria, the results were excellent in 53 cases and good in three. Moreover, both the full reduction rate and interbody fusion rate were 100%. Conclusion Posterior pedicle screw reduction and fixation, decompressive laminectomy plus massive autogenous bone grafting is one of the ideal treatments for lumbar spondylolisthesis, for it achieves satisfactory fixation, decompression, reduction and fusion.

关 键 词：脊柱损伤 脊椎滑脱 减压术 外科 骨移植 

分 类 号：R687.3[医药卫生—骨科学]