后路斜向腰椎关节固定术治疗腰椎退行性不稳

[目的]探讨应用后路斜向腰椎关节固定术（POLAr）治疗腰椎退行性不稳并神经根管狭窄的治疗效果。[方法]采用后路腰椎侧后方对神经根管彻底减压，后路斜向腰椎关节固定术，治疗腰椎退行性不稳并神经根管狭窄患者80例，男28例，女52例；平均年龄58．5岁；其中融合2个节段者56例，3个节段者20例，4个节段者4例。[结果]全部患者均安全完成手术，未出现神经系统并发症，术前症状完全缓解。经6个月～6a（平均2a）随访，除5例患者外都获得了牢固的椎间骨性融合；临床疗效：优62例，良15例，可3例，优良率95％。[结论]采用后路斜向腰椎关节固定术（POLAr）治疗腰椎退行性不稳，能够恢复椎问高度，重建腰椎轴向排列和载荷，能尽可能地保留脊柱后部结构，保持了脊柱的稳定性，植骨融合牢固，POLAr术式是一种有效治疗退变性腰椎不稳神经根管狭窄的手术方法。

Application of posterior oblique lumbar arthrodesis (POLAr) methods in degenerated lumbar spine instability with foraminal stenosis

[Objective]To examine the clinical outcomes of patients with a degenerated lumbar spine instability with foraminal stenosis treated by posterior oblique lumbar arthrodesis(POLAr).The short term and mid term clinical results were evaluated.[Method]There were eighty patients(28 male,52 female) with an average age of 56.5 years.From posterior approach,all patients underwent foraminal stenosis decompression and posterior oblique lumbar arthrodesis(POLAr).The interbody fusion two levels 56 patients,three levels 20 patients,four levels 4 patients.[Result]All patients underwent surgery safely without severe complications occurred such as infection and neurological damages.The average follow up time was 2 years(6 months~ 6 years) with complete relief of symptoms.Solid fusion was achieved in all but 5 patients at final follow up.The clinic results:excellent 62 patients,good 15 patients,fair 3 patients.95% of the patients obtained successful clinical outcome.[Conclusion]The utilizing posterior oblique lumbar arthrodesis(POLAr)can restore the height of disc space and withstand axial loading of the spine.With less invasive and preservation of part of the posterior elements of the lumbar spine and the solid fusion achieved,we consider it a sound procedure for the treatment of unstable degeneration with foraminal stenosis of lumbar spine.