内固定治疗退变性腰椎滑脱  

Treatment of degenerative lumbar spondylolisthesis with internal fixators

作　　者：张钟元[1] 张继东[1] 刘中远[1] 

机构地区：[1]上海第二医科大学附属仁济医院骨科,200001

出　　处：《上海医学》2002年第8期499-501,共3页Shanghai Medical Journal

摘　　要：目的　探讨运用减压、内固定、融合治疗退变性腰椎滑脱的临床疗效。方法　从 1993年 12月～2 0 0 1年 6月 ,对 5 8例退变性腰椎滑脱患者施行手术治疗。按Meyerding滑脱分类标准 :I度 5 2例 ,II度 6例 ;L3～ 4 滑脱 3例 ,L4～ 5滑脱 38例 ,L5～S1滑脱 17例。Dick内固定 3例 ,RF内固定 11例 ,Tenor内固定 5例 ,SO CON内固定 39例 ;小关节后外侧植骨融合 33例 ,椎体间植骨融合 8例 ,椎体间Prospace界面融合 17例。 结果　 5 6例获得随访 ,术后平均随访 32 .2个月 (10～ 72个月 )。X线片显示 :5 4例完全复位 ,骨融合 ;2例复位丢失 ,假关节形成 ;1例断钉 ;2例螺钉松动。临床效果评价 :优 2 5例 ,良 2 8例 ,可 1例 ,差 2例。结论　采用充分减压、椎弓根内固定、植骨融合或椎体间融合装置治疗退变性腰椎滑脱复位效果好 ,融合率高 。Objective To evaluate clinical outcome of degenerative lumbar spondylolisthesis with decompressive laminectomy, posterlateral of articulation of bone grafting fusion, intervertebral bone grafting fusion, interbody fusion with Prospace and solid transpedicle Dick、RF、Tenor and SOCON instrumentations.Methods From December 1993 to June 2001, 58 cases of degenerative lumbar spondylolisthesis were underwent surgery. According to Meyerding classification of lumbar spondylolisthesis, 52 cases were classified as degree I, 6 cases as degree II. The levels of spondylolisthesis were 3 cases at L 3-4, 38 cases at L 4-5, 17 cases at L 5S 1. The instrumentations were as follow: Dick 3 cases, RF 11 cases, Tenor 5 cases and SOCON 39 cases. The methods of fusion were as follow: 33 cases with posterlateral bone grafting, 8 cases with interverbral bone grafting, 17 cases with interbody Prospace fusion. Results 56 patients were followed up from 10 to 72 months with an average of 32.2 months. X-radiography demonstrated the complete reduction in 52 cases of fusion, the other 2 patients with infusion obtained incomplete reduction. One broken screw and two loosen instrumentations had been found . The clinical signs showed 25 cases of excellent, 28 cases of good, 1case of fair and 2 cases of bad.Conclusion Treatment of degenerative lumbar spondylolisthesis with internal fixators had achieved satisfactory clinical results and relatively high fusion rate.

关 键 词：减压 疗效 脊柱融合术 内固定 治疗 退变性腰椎滑脱 

分 类 号：R681.5[医药卫生—骨科学]