腰椎滑脱的减压、内固定与融合术

目的观察采用腰椎管减压、横突间植骨、Cage椎间融合器和SOCON内固定治疗腰椎滑脱合并腰椎管狭窄的早期疗效。方法从1997年12月～1999年12月,对38例腰椎滑脱患者采用腰椎管减压,横突间植骨和SOCON内固定手术进行治疗。术前X线检查按Meyerding分度,Ⅰ度滑脱32例,Ⅱ度滑脱6例;L4,5滑脱29例,L5S1滑脱9例。结果术后平均随访18.2个月(14～26个月),比较手术前后临床症状和X线片滑脱复位程度,38例患者中,31例症状完全消失,优良率为81.6%。32例Ⅰ度滑脱完全复位,4例Ⅱ度滑脱完全复位,2例Ⅱ度滑脱复位达90%,解剖复位率达94.7%。结论应用SOCON内固定治疗腰椎滑脱,效果良好,复位满意。

Treatment of lumbar spondylolisthesis with decompressive laminetomy, bone grafting and solid SOCON instrumentation

Objective To observe the early clinical outcome of the lumbar spondylolisthesis treated with decompressive laminetomy, intertransverse process arthrodesis with bone grafting, interbody fusion cage and solid transpedicle SOCON instrumentation. Methods From December 1997 to December 1999, 38 cases of lumbar spondylolisthesis were treated with decompression for spine canal stenosis. And intertransverse process arthrodesis was done by means of bone chip grafting obtained from the iliac crest, or the interbody fusion cage and the SOCON system. According to Meyerding classfication of lumbar spondylolisthesis, 32 cases were classified as degree 1, 6 cases as degree 2. The levels of lumbar spondylolisthesis was between L 4 and L5 in 29 patients and between L 5 and S 1 in 9 cases. Results The patients were followed up from 14 to 26 months with an average of 18.2 months. The results showed that the pre operative clinical symptoms disappeared completely in 31 of 38 patients. Pain relief was seen in 81.6%. 32 cases with degree 1 and 4 of 6 cases with degree 2 obtained the complete reduction of the slide intervertebral body. Anatomical reduction rate was 94.7%. The other 2 cases of the degree 2 patients obtained 90% of reduction. No infection or neurologic complication occurred in this series. Conclusion Treatment of lumbar spondylolisthesis with SOCON system has satisfactory reduction rate and excellent clinical results.