节段固定结合单枚椎间融合器治疗腰椎滑脱症

目的评估椎弓根钉撑开、复位、固定系统结合单枚Cage手术治疗腰椎滑脱症的临床效果。方法腰椎滑脱症患者38例,男16例,女22例;年龄22～69岁(平均44.8岁)。根据Meyerding分级:Ⅰ度滑脱20例、Ⅱ度14例、Ⅲ度4例;峡部裂滑脱22例,退变滑脱16例;单节段滑脱32例,双节段6例。采用后路节段性固定加单枚Cage斜放椎间融合方法进行治疗。结果本组38例均获得随访,时间6~34个月,平均16个月。根据Nakai评分标准评价,优20例,良15例,可2例,差1例,优良率92%。术后6~16个月,X线示椎体间植骨融合36例,融合率94.7%,无高度及复位丢失。结论选择个性化的减压,应用单枚Cage椎间融合椎弓根固定是一种比较理想的腰椎滑脱症治疗术式。

Treatment of lumbar spondylolisthesis with segment fixation and monocage

Objective To evaluate the effect of the spondylolisthesis treated by pedicle screw combined with monocage.Methods 38 cases of lumbar spondylosisthesis were treated with posterior decompression,segment transpedicular screw rod fixation,and with single fusion cage inserted.Acording to Meyerding standard,all cases were classified to 20 cases of I degree spondylolisthesis,14 cases of II degree,4 cases of III degree.22 cases had true lumbar spondylolithesis,16 cases had untrue lumbar spodylolisthesis.Results All the 38 caases were followed up 6~36 months(mean,16 months).Acoording to Nakai’s evaluation criteria,the results were excellent in 20 cases,good in 15 cases,fair in 2 cases,and poor in 1 case.The excellent and good rate were 92%.36 cases of all the patients achieved successful radiograghic fusion(fusion rat,94.7%)6~16 months post operation.Conclusion For lumbar spondylilisthesis,the treatment technique through personal discompression,segment pedicle screw fixation and mono-cage is an ideal operation method.