腰椎崩裂性滑脱椎弓根钉复位内固定后外侧植骨融合术  

Spondylodesis by posterlateral fusion and transpedicular fixation in the treatment of spondylolisthesis

作　　者：方文[1] 徐玉良[1] 巢金林[1] 

机构地区：[1]解放军第102医院骨科,江苏常州213003

出　　处：《颈腰痛杂志》2002年第2期107-109,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的　比较分析椎弓根钉复位内固定 +后外侧直骨融合术与单纯后外侧植骨融合术治疗腰椎崩裂滑脱的疗效。方法　统计分析我院 1987.1～ 2 0 0 0 .1,97例腰椎崩裂性滑脱病人行椎弓根钉复位内固定 +后外侧植骨融合术后 2年的情况 ,内固定于术后一年取出。结果　植骨融合率为 92 .8%(7例未融合 )。腰腿痛症状改善的评价采用 JOA标准 ,术前平均为 15分 ,术后平均为 2 3分 ,(满分为 2 9分 ) ,术前 9.3%(9人 )能参加一般的体力劳动和干家务活 ,术后 75 .3%(73人 )的人能参加一般的体力劳动和干家务活。术前平均滑脱 41%,术后 (去除内固定后一年 )平均滑脱15 %,并发症发生率 6 1%,其中断钉发生率 42 .3%,绝大多数并发症临床上无重要意义。结论　椎弓根钉复位内固定 +后外侧植骨融合术能有效矫正腰椎滑脱 ,增加植骨融合率 ,缩短术后卧床休息时间 ,但并发症较单纯后外侧植骨融合术多。Objective To compaire the results of lumbar or lumbosacral posterolateral fusion with pedicle screw internal fixation and posterolateral fusion without implants.Methods Ninety-seven patients having lumbar or lumbosacral posterolateral fusion with pedicle screw internal fixation were reviewed retrospectively two years after the fusion.In 97 patients,the underlying condition was spondylolisthetic.The internal device was removed one year after the fusion.Results The fusion rate was 92.8%.The disability was assessed by the JOA score.The mean score was 15 preoperatively,and 23 two years after the fusion.Preoperatively,only 9 patients was able to work;two years after operation,almost 73 patients held jobs.Complications due to internal fixation were recorded in 61% of the cases.Most of these,such as screw breakage and screw loosening in the sacrum,were of no clinical importance.Conclusions The use of internal fixation seems to enhance the fusion rate but is associated with more complications than posterolateral fusion without implants.

关 键 词：腰椎滑脱 椎弓根钉 后外侧植骨融合 

分 类 号：R687.32[医药卫生—骨科学] R681.5[医药卫生—外科学]