SOCON内固定器在治疗腰椎退行性滑脱中的应用

目的 观察腰椎管减压、横空间植骨和ＳＯＣＯＮ内固定手术治疗不稳定型退行性腰椎滑肿合并腰椎管狭窄患者的早期临床疗效。方法 从１９９７年１２月～１９９９年１月，２１例腰椎退行性滑脱合并腰椎管狭窄的患者，经长期（６～１２个月）严格保守治疗失败后，入院接受腰椎管减压、横空间植骨和ＳＯＣＯＮ内固定手术。２１例中表现为下腰痛、间歇性跛行者１９例，下肢疼痛者８例。经术前Ｘ线检查证实ＭｅｙｅｒｄｉｎｇⅠ度滑脱１８

The treatment of degenerative lumbar spondylolisthesis with transpedicle instrument of solid connection system

Objective To observe the early clinical outcome of the instable degenerative lumbar spondylolisthesis treated by decompressive laminectomy, intertransverse process arthrodesis with bone grafting and transpedicle instrument of solid connection(SOCON) system. Methods From December 1997 to January 1999, twenty-one patient, were diagnosed as degenerative lumbar spondylolisthesis accompanied by lumbar canal stenosis by the imaging studies of plain radiographs, myelogram, computerized tomography scan and MRI. There were 6 males and 15 females, aged from 30 to 77 years old, with an average of 53.3 years. The clinical manifestations of the patients included intermittent claudication in 19, pain of lower extremity in 8. According to Meyerding classification system of lumbar spondylolisthesis, 18 cases were classified as degree 1, 3 cases degree 2. The levels of lumbar spondylolisthesis was between L 3 and L 4 in 2 patients, between L 4 and L 5 in 12, between L 5 and S 1 in 7. The decomprssion of the spinal canal stenosis was achieved by lumbar laminectomy, the concomitant intertransverse process arthrodesis was performed by means of bone chip grafting harvested from the iliac crest, and SOCON system was installed by pedicle screw fixation devices. Results The patients were followed up from 3 to 16 months, with an average of 8.3 months. The results showed that the pre-operative clinical symptoms disappeared completely in 19 of 21 patients,pain relief was seen in 90.5%. 17 of 18 cases with degree 1 and 2 of 3 degree 2 spondylolisthesis obtained complete reduction of the olisthy vertebral bodies, anatomical reduction rate was 90.5%. No infection or neurologic complication occurred in this series. Two cases suffered from residual symptoms. One case sustained residual low back pain, which received the three segmental lumbar fixations, because of the two lumbar spondylolisthesis,another one was associated with cervical and thoracic stenosis, the claudication of this case did not recovered completely. Conclusion This study showed decompressive laminectomy, intertransverse process arthrodesis and transpedicle instrument of SOCON system in the treatment of lumbar spondylolisthesis have the advantages of satisfactory preliminary clinical result, high reduction rate and low complication.