椎间打压植骨融合椎弓根钉内固定术治疗腰椎滑脱症疗效评价

目的 评价椎间打压植骨融合椎弓根钉内固定术治疗腰椎滑脱症的临床疗效.方法 2003年1月至2007年10月收治的腰椎滑脱症患者39例,其中退变性滑脱14例,峡部裂性滑脱25例.L4椎体滑脱22例,L5k椎体滑脱17例.按Meyerding滑脱程度分级标准:Ⅰ度滑脱11例,Ⅱ度滑脱27例,Ⅲ度滑脱1例.C型臂X线机透视定位下在滑脱椎体及其下位椎体间植入椎弓根螺钉,行滑脱椎体全椎板减压术,安放固定棒并撑开椎间隙,进行滑脱椎体复位及临时固定,处理椎间隙,行椎间打压植骨融合术,调整钉棒进行椎间适度加压,以植骨块稳定为度.结果 本组患者全部获得随访,随访时间5个月至4年,平均15个月.滑脱椎体完全复位28例,不完全复位11例.采用Prolo腰椎术后功能评定标准,治愈35例,有效4例,无效0例.结论 椎间打压植骨融合椎弓根钉内固定术是治疗腰椎滑脱症的一种安全、有效术式,融合率高,费用较低,易被患者接受和选择.

The evaluation of curative effect for lumbar spondylolisthesis by posterior lumbar intervertebral compression bone graft fusion and pedicle screw internal fixation

Objective To investigate the curative effect for lumbar spondylolisthesis by posterior lumbar intervertebral compression bone graft fusion and pedicle screw internal fixation.Method All 39 cases with lumbar spondylolisthesis accepted treatment during January 2003 to October 2007.There were cataplasia spondylolisthesis in 14 cases and isthmic spondylolisthesis in 25 cases.Twenty-two cases had spondylolisthesis in L4 and 17 cases had spondylolisthesis in L5.According to Meyerding grading,11 patients were classified as degree Ⅰ lesion.27 patients as degree Ⅱ lesion and 1 patient as degree Ⅲ lesion.By the help of X-ray machine,pedicle screw Was embedded in the vertebral spondylolisthesis and it Was lower vertebra.Laminectomy decompress was administered in vertebral spondylolisthesis and hold-down bars was placed to open intervertebral space.Then restored the vertebral spondylolisthesis and fixed it temporary.Next,intervertebral compression bone graft fusion was finished and was adjusted.Results Follow-up period was 5 months to 4 years.Clinical outcomes were measured with Prolo evaluation scale,35 cases were cured,4 cases were good effect.Conclusions This operation has been found to be asafe,rapid and effective method for lumbar spondylolisthesis and it produces a high fusion rate and lower expense.