充分减压后撑开椎间隙提拉复位并经椎间孔椎间融合内固定治疗中重度峡部裂型腰椎滑脱症疗效观察  

Curative effect observation on treatment of moderate-to-severe isthmic spondylolisthesis with sufficient decompression to distract intervertebral space for spondylolisthesis reduction and interforaminal fusion internal fixation

作　　者：李忠伟 张树文 杨新明 银乐乐 周坤 崔泳[1] LI Zhongwei;ZHANG Shuwen;YANG Xinming;YIN Lele;ZHOU Kun;CUI Yong(Department of Spine Surgery,Xinjiang Medical University Fifth Affiliated Hospital,Urumqi,Xinjiang 830000,China;不详)

机构地区：[1]新疆医科大学第五附属医院脊柱外科,新疆乌鲁木齐830000 [2]新疆维吾尔自治人民医院骨科中心脊柱外科,新疆乌鲁木齐830000

出　　处：《中国骨与关节损伤杂志》2024年第7期683-686,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的观察充分减压后撑开椎间隙、提拉复位、经椎间孔椎间融合内固定治疗中重度峡部裂型腰椎滑脱症的可行性及临床疗效。方法回顾性分析自2014-01—2021-06诊治的27例中重度峡部裂型腰椎滑脱症,采用充分减压后撑开椎间隙、提拉复位、经椎间孔椎间融合内固定手术治疗。比较术前与术后2周腰背痛VAS评分,术前与术后6个月ODI指数。结果本组手术时间180~245 min,平均223.2 min;术中出血量100~250 mL,平均110.0 mL。27例均获得随访,随访时间为9~16个月,平均11.2个月。随访期间未出现切口深部感染、内固定松动、椎体再滑脱等并发症。椎间融合时间为8~14个月,平均9.9个月。术后2周腰背痛VAS评分为(1.70±0.46)分,较术前(5.00±1.03)分明显降低,差异有统计学意义(t=5.210,P<0.001)。术后6个月ODI指数为(19.90±3.41)%,较术前(53.93±5.89)%明显降低,差异有统计学意义(t=12.750,P<0.001)。结论充分减压后撑开椎间隙、提拉复位、经椎间孔椎间融合内固定治疗中重度峡部裂型腰椎滑脱症可以取得满意疗效,在获得解剖复位融合的同时确保了手术安全性,术后并发症发生率低。Objective To observe the feasibility and clinical effect of space extension under sufficient decompression,spondylolisthesis reduction and through interforaminal fusion and internal fixation for the treatment of moderate-to-severe isthmic spondylolisthesis.Methods Twenty-seven patients with moderate-to-severe isthmic spondylolisthesis were retrospectively analyzed,who were diagnosed and treated with sufficient decompression to distract intervertebral space for spondylolisthesis reduction and interforaminal fusion internal fixation from January 2014 to June 2021.The low back pain VAS scores preoperatively and 2 weeks postoperatively were compared as well as ODI indices preoperatively and 6 months postoperatively.Results The operation time in this group ranged from 180 to 245 min,with an average of 223.2 min;intraoperative bleeding ranged from 100 to 250 mL,with an average of 110.0 mL.Follow-up was obtained in all 27 cases and ranged from 9 to 16 months,with a mean of 11.2 months.There were no complications such as deep incision infection,internal fixation loosening,or vertebral re-slip during the follow-up period.The time of interbody fusion ranged from 8 to 14 months,with a mean of 9.9 months.The VAS score for low back pain at 2 weeks postoperatively was(1.70±0.46),which was significantly lower than that preoperatively(5.00±1.03),and the difference was statistically significant(t=5.210,P<0.001).The ODI index at 6 months postoperatively was(19.90±3.41)%,which was significantly lower than that preoperatively(53.93±5.89)%,and the difference was statistically significant(t=12.750,P<0.001).Conclusion The treatment of moderate-to-severe isthmic spondylolisthesis with sufficient decompression to distract intervertebral space for spondylolisthesis reduction and interforaminal fusion internal fixation can achieve satisfactory efficacy,ensure surgical safety while obtaining anatomical repositioning and fusion,and have a low incidence of postoperative complications.

关 键 词：峡部裂型腰椎滑脱症 椎间孔入路 提拉复位 脊柱融合术 

分 类 号：R687.3[医药卫生—骨科学]