椎间融合器治疗腰椎滑脱症临床观察  

The Treatment of Degenerative Lumbar Spondylolisthesis with Interveterbral Threaded Fusion Cage(TFC)

作　　者：张西峰[1] 王岩[1] 张伯勋[1] 王继芳[1] 肖嵩华[1] 刘桂林[1] 董纪元[1] 

机构地区：[1]解放军总医院骨科,北京复兴路28号100853

出　　处：《中国矫形外科杂志》2002年第9期856-857,共2页Orthopedic Journal of China

摘　　要：目的 :观察螺纹状椎间融合器 (ThreadedFusionCoge ,TFC)治疗不稳定性腰椎滑脱的临床疗效 ,观察TFC对腰椎前凸的影响。方法 :1997年 11月～ 2 0 0 0年 3月 ,3 1例经过保守治疗无效的腰椎滑脱患者 ,接受手术治疗。 3 1例中L4～ 518例 ,L5S113例。按Meyerding分类大于Ⅰ度滑脱 2例 ,其余均在Ⅰ度以内。患者行后路椎管减压 ,同时单间隙置入 2枚螺纹状椎间融合器 (TFC)。观察术前、术后和随访期间Taillard指数、Boxall指数、腰骶关节角、椎间高度指数的变化。观察矢状面脊柱序列的变化。结果 :2 9例患者 3月内症状显著减轻 ,随访期间病情稳定 ,症状没有复发。术前、术后和随访期间Taillard指数、Boxall指数没有变化。术后腰骶关节角增加 ,并且随访期间没有丢失。手术后椎间隙高度增加 1倍 ,随访期间维持到增加 5 0 %。 3 1例获得随访 2 2例 ,优 18例 ,良 3例 ,一般 1例 ;优良率 95 .5 %。结论 :椎间融合器治疗Ⅰ度腰椎滑脱症进行椎体间融合早期获得良好的临床治愈率 ,并发症低。Objective:To observe the clinical outcome of the degenerative lumbar spondylolisthesis treated by threaded fusion cage(TFC).Methods:From Nov.1997 to Mar.2000,31 patients had diagnozed as lumbar spondylolisthesis were treated with TFC.The levels of spondylolisthesis were L 4～5 in 18 cases,L 5～S 1 in 13 cases.According to Meyerding's classification,29 cases were Ⅰ degree,2 cases were over Ⅰ degree.All of the patients received posterior decompression and pairs TFC were inserted side by side in lumbar intervertebral space.Taillard,Boxall,Lumbosacral angle and intervertebral height index were measured.Spinal contour was observed.Results:The largest percentage of pain relief and functional improvements occurred by 3 months,and these improvements were maintained.There were no change in Taillard,Boxall methods.Lumbosacral angle increased and did not lose during following up.Intervertebral height index increased 100% after operation and was maintained 50%.Among 31 cases,22 cases got follow up.The excellent rate was 95.5%.Conclusion:This study indicates that the early positive benefits of interbody fusion cage procedures maintained a lower complication rate and better results.Intervertebral height index is a kind of mensurable method to analyze the change of intervetebral space.

关 键 词：腰椎滑脱 椎间融合器 放射学诊断 治疗 

分 类 号：R681.57[医药卫生—骨科学]