后路减压、融合器植骨、钉棒系统治疗退行性腰椎滑脱症45例

目的：腰椎后路减压、椎间融合器植骨融合、钉棒系统内固定术治疗退行性腰椎滑脱症临床疗效观察。方法：我科自2005年4月-2012年4月对45例退行性腰椎滑脱症患者常规行腰椎后路减压、椎间融合器植骨融合、钉棒系统内固定术。所有患者术前、术后及随访时均进行腰椎影像学（X线及CT检查）检查,并测量术前术后椎间隙高度变化、观察术后患者腰椎融合率、腰椎滑脱复位率、进行JOA评分、Macnab评分。结果：按Macnab标准评分,术后24个月疗效评价优38例,良5例,中1例,差1例,优良率为95.4%（43/45）;45例患者均按病情定期随访,根据腰椎JOA评分,术后24个月平均腰椎滑脱症状治疗改善为（6.3±1.3）,使用SPSS软件进行统计学分析后,术后及随访时与术前相比均有统计学意义（P〈0.05）;随访时患者均诉疼痛症状明改善,生活质量明显提高。结论：腰椎后路减压、椎间融合器植骨融合、钉棒系统内固定术治疗退行性腰椎滑脱症可以明显解除患者痛苦,改善患者生活质量,能有效重建脊柱稳定性,提高融合率,解除神经缺血症状,是一种安全、有效的手术方式。

Observation of the Operation combined with Posterior Decompression,Intervertebral Fusion and Internal Fixation by Nail-stick System in Lumbar Spondylolisthesis

objective：To observe the clinical effect of operation combined with posterior decompression,intervertebral fusion,and internal fixation by nail-stick system in lumbar spondylolisthesis.Methods：All 45 patients of lumbar spondylolisthesis were treated with the operation combined with posterior decompression,intervertebral fusion and internal fixation by nail-stick system from Apr 2005 to Apr 2012.All of the patients were received imaging studies before and after the operation,and the curative effect was evaluated.Results：All 45 cases were followed up for 2years.According to Macnab standard score,the postoperative effect was 38 cases in excellent,8cases in good,1case in moderate,and 1case in poor.The improvement rate was 6.3±1.3after the operation by JOA score（P〈0.05）.The symptoms and the quality of life improved significantly after the operation.Conclusion：The operation combined with posterior decompression,intervertebral fusion,and internal fixation by nail-stick system can safely relieve symptoms,improve life quality and reconstruct spinal stability in lumbar spondylolisthesis.