272例腰椎滑脱症手术治疗疗效观察  

Study on the curative effect of 272 cases of lumbar spondylolisthesis

作　　者：杨明礼 蒋成[2] 张超[2] YANG Ming-li;JIANG Cheng;ZHANG Chao(Dazhou Orthopedic Hospital,Dazhou 635000;Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan China)

机构地区：[1]达州骨科医院,四川达州635000 [2]川北医学院附属医院,四川南充637000

出　　处：《川北医学院学报》2018年第4期612-616,共5页Journal of North Sichuan Medical College

摘　　要：目的:探讨腰椎滑脱症手术治疗效果、手术适应症、手术技巧及手术并发症。方法:回顾性分析272例因腰椎滑脱症行后路切开复位、减压、椎弓根螺钉内固定、椎间融合术患者的临床资料。术后平均随访16个月,末次随访时按JOA腰痛评分系统进行疗效评定,并行腰椎X线摄片,分析获得的数据。结果:末次随访临床效果优良率92.6%,复位率86.3%,椎间融合率96.5%。术前JOA腰痛评分(11.2±0.1)分,术后评分(24.1±2.1)分,术前椎间隙高度(6.6±1.4)mm,术后椎间隙高度(11.9±2.1)mm,术前滑脱距离(17.6±5.4)mm,术后滑脱距离(1.0±0.6)mm,各项指标与术前比较,差异都有统计学意义(P<0.05)。结论:腰椎滑脱症患者经手术治疗后可获得良好临床疗效,但需严格掌握手术适应症,精准的手术技巧,良好的术后管理。Objective： To study the surgical treatment effect of lumbar spondylolisthesis,surgical indications,surgical techniques and complications. Methods： The clinical data of 272 cases of lumbar spondylolisthesis treated by open reduction,decompression,pedicle screw fixation and interbody fusion were retrospectively analyzed. Average follow-up for 16 months after surgery,and the results were evaluated according to the JOA waist pain scoring system,parallel lumbar X-ray film,and analyzed the date. Results： After 16 months of follow-up,the clinical efficacy was 92. 6%,the reduction rate was 86. 3%,and the intervertebral fusion rate was 96. 5% after the operation. Preoperative JOA score was 11. 2 ± 0. 1,postoperative lumbar pain score was 24. 1 ± 2. 1,preoperative intervertebral disc height was 6. 6 ± 1. 4 mm,the height of the intervertebral disc height was 11. 9 ± 2. 1 mm,preoperative slip distance of 17. 6 ± 5. 4 mm,slip distance of 1. 0 ± 0. 6 postoperatively. The indicators had significant difference compared with preoperative（ P〈0. 05）. Conclusion：Patients with lumbar spondylolisthesis have good clinical efficacy after surgical treatment,but need to master the operation indications strictly,precise surgical technique,postoperative management of good.

关 键 词：腰椎滑脱 后路减压 椎弓根螺钉内固定 椎间融合 

分 类 号：R687.4[医药卫生—骨科学]