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椎弓根钉系统结合椎间融合治疗严重腰椎滑脱
引用本文:尹承慧,符臣学,徐皓,叶永平.椎弓根钉系统结合椎间融合治疗严重腰椎滑脱[J].脊柱外科杂志,2009,7(2):85-88.
作者姓名:尹承慧  符臣学  徐皓  叶永平
作者单位:南京军区福州总医院骨科研究所,福建,350025
摘    要:目的评价椎弓根钉内固定系统结合椎间融合治疗严重腰椎滑脱的临床效果。方法2002—2007年应用后路椎弓根钉内固定系统结合椎间融合器治疗32例重度(Meyerding分级Ⅲ和Ⅳ度)腰椎滑脱患者,椎间隙Cage植骨。随访时采用Suk标准判断融合情况,并根据神经损害体征、腰部活动功能和对职业的影响等指标进行疗效评价。结果随访6~36个月,平均22.5个月,优良率90.6%,融合率84.4%,平均腰椎滑脱率由术前的57.3%降低到术后的12.2%。术后并发脑脊液漏2例,暂时性单侧根性疼痛2例,足背皮肤麻木伴轻度的踝关节背屈肌力减弱3例,Cage下沉5例,平均下沉1.1mm。结论椎弓根钉内固定系统结合Cage椎间植骨融合器是治疗严重腰椎滑脱的一种比较安全有效的手术选择。

关 键 词:腰椎  脊椎前移  内固定器  脊柱融合术
收稿时间:2008/8/14 0:00:00

Application of transpedicle screw fixation system combined with interbody fusion in severe lumbar spondylolisthesis
YIN Chenghui,FU Chenxue,XU Hao and YE Yongping.Application of transpedicle screw fixation system combined with interbody fusion in severe lumbar spondylolisthesis[J].Journal of Spinal Surgery,2009,7(2):85-88.
Authors:YIN Chenghui  FU Chenxue  XU Hao and YE Yongping
Institution:Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Command, Fuzhou
Abstract:Objective To evaluate the curative effect of transpediele screw fixation system combined with interbody fusion in severe lumbar spondylolisthesis. Methods From 2002 January to 2007 December, 32 patients of high-grade lumbar spondylolisthesis (Meyerding grade Ⅲ and Ⅳ ) underwent surgical treatment of transpedicle screw fixation system combined with interbody fusion. In the operation procedure, cages implanted for interbody fusion were carried out. In the follow-up, the fusion was appreciated in accordance with Suk' s criterion. The curative effect was evaluated according to items of nerve injury, low back function and effect upon career. Results The follow-up were 6 to 36 months, averaged 22.5 months. The outcome of 29 cases was considered to be excellent or good (90.6%). The fusion rate was 84.4% (27/32). Mean slip rate reduced from 57.3% to 12.2%. Two cases encountered cerebrospinal fluid leak. Unilater radical pain occurred temporally in 2 cases. Three patients felt anaesthesia in dorsum of foot, and slight myosthenic weaken of ankle dorsiflexion. There were 5 patients whose cages subsided. Mean subsidence was 1.1 mm. Conclusion Transpedicle screw fixation system combined with interbody fusion was a safe and effective surgical procedure for severe spondylotisthesis.
Keywords:Lumbar vertebrae  Spondylolisthesis  Internal fixators  Spinal fusion
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