青壮年腰椎峡部不连性滑脱行椎间融合手术的疗效分析  

Effect of intervertebral fusion cage in the treatment of young adults with lumbar isthmic spondylolisthesis

作　　者：高应超 费正奇 刘海峰 陈波 韩敬凛 GAO Ying-chao;FEI Zheng-qi;LIU Hai-feng;CHEN Bo;HAN Jing-bing(Department of Spinal Surgery,the 942nd Hospital of the Joint Service Support Force,Yinchuan,Ningxia,750004,China)

机构地区：[1]解放军联勤保障部队第942医院骨科中心脊柱外科病区,宁夏银川750004

出　　处：《颈腰痛杂志》2020年第2期143-145,150,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：宁夏回族自治区自然科学基金(编号:NZ16212)。

摘　　要：目的探讨青壮年腰椎峡部不连性滑脱采用椎间融合手术的疗效。方法回顾2012年1月-2017年1月采用椎间融合及短节段钉棒固定手术治疗的青壮年腰椎峡部不连患者31例,随访前后采用JOA评分及VAS评分进行疗效评价,通过影像学资料评估滑脱率、滑脱角和椎间隙高度在治疗前后的改变。结果所有患者均获得12~24个月的完整随访,术后JOA、VAS评分较治疗前显著改善,差异有统计学意义(P<0.05);术后腰椎椎体滑脱率、滑脱角、椎间隙高度较术前明显改善或恢复,差异有统计学意义(P<0.05)。X线片及CT复查示融合位置均获骨性愈合;随访期间无继发性椎体滑脱,无下肢神经症状加重,无椎弓根钉及融合器断裂或松动发生。结论椎间融合联合短节段固定手术治疗青壮年腰椎峡部不连性滑脱,可使滑脱腰椎基本复位,腰椎滑脱角明显减少,椎间隙高度基本恢复,是青壮年腰椎峡部不连性滑脱的有效治疗方案。Objective To evaluate the clinic effect of intervertebral fusion cage in the treatment of young adults with lumbar isthmic spondylolisthesis.Methods From January 2012 to January 2017, the clinical data of 31 young adults with lumbar isthmic spondylolisthesis who underwent intervertebral fusion cage with short segment screw-rod fixation system were retrospectively analyzed.JOA score and visual analog scale( VAS) score were used to evaluate the clinical effect during postoperative follow-up.Changes of slippage rate,slippage angle and intervertebral space post height in preoperative and postoperative periods were evaluated by iconography data.Results All patients were followed up for 12-24 months,JOA score and VAS score of all patients were improved after treatment,and the differences were statistically significant compared with before treatment( P<0.05).The slippage angle,the slippage rate and the height of the intervertebral space were improved after treatment,and the differences were statistically significant compared with preoperation( P<0.05).X-ray films and CT showed bone fusion in the area.During follow-up,no secondary lumbar spondylolyses,complications of lower limbs nerve symptom,or loosening or breaking of internal fixator were found.Conclusions Postoperative lumbar spondylolisthesis is basically reset,the slippage angle is significantly reduced,and the height of the intervertebral space is recovered basically.Intervertebral fusion cage with short segment screw-rod fixation system is a reliable and effective treatment for isthmic spondylolisthesis of young adults.

关 键 词：峡部不连型腰椎滑脱症 内固定 椎间融合 青壮年 

分 类 号：R681.5[医药卫生—骨科学]