腰椎滑脱并腰椎间盘突出症的手术治疗及疗效

目的探讨腰椎滑脱合并腰椎间盘突出症的手术治疗及疗效。方法 2007年9月至2012年4月,对本院44例腰椎滑脱并腰椎间盘突出症的患者,应用后路全椎板减压、髓核摘除,椎弓根螺钉复位内固定后,分别采用后外侧植骨融合术、后路椎体间植骨融合术。比较不同手术的时间、出血量术后及随访时疗效。摘除椎间隙44个,融合节段44个。滑脱主要部位为L4、5和(或)L5S1,滑脱度为Ⅰ~Ⅱ度。结果术后随访6~36个月,复查X线片,无断钉、断棒及松动现象,优良40例,可3例,差1例,优良率90.9%。结论腰椎滑脱并腰椎间盘突出症,宜选用后路椎弓根螺钉固定不稳节段,采用后外侧植骨融合和(或)后路椎体间植骨融合可获得较好疗效。

Surgical Treatment and Curative Effectiveness of Lumbar Olisthe and Lumbar Intervertebral Disc Herniation

Objective To explore the surgical treatment and curative effect of lumbar olisthe and lumbar intervertebral disc herniation.Methods From September 2007 to April 2012,44 cases with lumbar olisthe and lumbar intervertebral disc herniation firstly underwent posterior laminectomy,discectomy and pedicle screw interanl fixation,then treated by posteolateral fusion and posterior interbody fusion between vertebral bodies,and finally the operation time,amount of bleeding and therapeutic effectiveness’s at the ending of courses were compared.Totally,44 intervertebral disc were excised and 44 sections were fused.The olisthe sites mainly occurred at L4,5or L5S1,grade ranged from I to II.Results Postoperative follow-up 6~36 months,X-ray showed that no nail breakage and loosen were found.44 cases were excellent,3 cases were good and 1 case was bad,the excellent and good rate was 90.9%.Conclusion The optimal treament of lumbar olisthe and lumbar intervertebral disc herniation was firstly fixed the unstable sections with posterior pedicle screws and then posterolateral lumbar fusion or posterior lumbar interbody fusion.