腰椎峡部裂和滑脱症外科治疗的探讨

报告自１９６５～１９９１年９２例有症状的腰椎峡部裂和滑脱的外科治疗。１９６５～１９７１年采用经腹椎体间前植骨融合２２例； １９７１～１９７８年采取腹膜外入路椎间植骨融合或Ｒｏｍｂｏｌｄ法后外侧融合术２０例；１９８７～１９９１年峡部裂处植骨、螺钉和横突钢丝内固定１５例，短节段经椎寻根内固定３５例，其中改良Ｄｉｃｋ法７例．Ｓｔｅｆｆｅｅ槽式钢板２８例，同时行后外侧融合。作者认为，症状性的腰椎峡部裂或轻微滑脱，峡部可直接修整植骨、螺钉和横突钢丝固定。滑脱椎可采用经椎弓根Ｓｔｅｆｆｅｅ槽式钢板螺钉得到完全或部分复位．

Surgical treatment of spondylolysis and spondylolisthesis

From 1965 to 1991, 92 patients who had symptomatic spondylolysis or spondylolisthesis were operated with the through abdominal intervertebral fusion in 22 cases (1965- 1971), extraperitoneal approach or Rombold posterolateral fusion for 20 cases (1971-1978), bone grafting and internal fixation of the defect of the pars interarticularis with screw and transverse processes wire fixation for 15 cases (1987-1991) and short segment pedicular fixation conbined with posterolateral fusion for 35 cases. Among the 35 cases, there were modified Dick method 7 cases and Steffee's variable screw placement (VSP) on slotted plates and transpedicular screws 28 cases. The symptomatic spondylolysis or minimal degree of spondylolisthesis may be repaired of by bone grafting and internal fixation with screw and wires. Complete or partial control of the displaced vertebrae were gained through the Steffee's transpedicular screw plates.