椎间植骨椎弓根内固定治疗腰椎退行性病变

目的：观察腰椎板切除减压、自体椎间植骨融合椎弓根内固定治疗腰椎退行性病变的近期临床疗效。方法：采用腰椎板切除减压、自体椎间植骨融合椎弓根内固定治疗腰椎退行性病变患者23例，其中腰椎管狭窄症12例，腰椎滑脱7例（均为Meyerding Ⅰ度），腰椎节段不稳4例。随访观察近期临床疗效、椎间隙高度及融合率。结果：23例获得随访，时间5—38个月，平均16个月。按照改良Macnab法疗效评定标准，优15例，良7例，可1例，优良率96％。术后3～8个月（平均5个月）X线示椎体间植骨融合，融合率100％，无高度及复位丢失。椎间隙高度增大3．6mm，腰椎前凸角增大6．2°。结论：椎间植骨融合椎弓根内固定，有效恢复脊柱生理弧度及椎间隙高度，达到即时稳定，椎间植骨融合率高，临床疗效满意。

Treatment of Lumbar Spine Degenerative Deseases with Vertebral Pedicle Internal Fixation and Intervertebral Fusion

Objective：To investigate the short term clinical efficiency of vertebral pedicle internal fixation and intervertebral fusion in treatment of lumbar spine degenerative deseases. Methods ：23 cases were treated with extensive vertebral lamina decompression and vertebral pedicle internal fixation and intervertebral fusion. The lumbar spinal canal stenosis was in 12 cases, degenerative lumbar spondylolisthesis in 7 and instability in 4. The short term clinical effect and the intervertebral space height and the fusion rate of bone were observed. Results：All 23 cases were followed up for 5 -38 months with an average of 16 months. According to the modified Macnab outcome criteria, the outcomes were excellent in 15 cases, good in 7 and fair in 1, and the excellent and good rate was 96%. X-ray films showed that bone union between the vertebral within 3 -8 months（ averaged 5 months） after operation, the fusion rate was 100%, there was no loss in intervertebral space height and reposition. The intervertebral space height was increased 2.4 - 6.0 mm, averaged 3.6mm. The angle of lumbar was increased 3 - 130 , averaged 6.20 . Conclusions ：Vertebral pedicle internal fixation and intervertebral fusion can restore the spinal physiologic curve, maintain the intervertebral space height, achieve instantly stabilization, increase the fusion rate and elevate the clinical effect.