椎间融合器结合椎弓根内固定治疗腰椎滑脱症

目的探讨采用经后路椎间融合器结合椎弓根内固定治疗腰椎滑脱症的效果。方法29例腰椎滑脱症患者,其中Ⅰ度滑脱12例,Ⅱ度滑脱14例,Ⅲ度滑脱3例;退变性腰椎滑脱10例,峡部裂性腰椎滑脱19例。经后路采用椎间融合器结合椎弓根内固定进行减压融合手术治疗,比较手术前后临床症状、体征及影像学资料。术后随访24～41个月(平均38个月)。结果术后3个月内,优20例,良8例,可1例,优良率96.6%。23例滑脱解剖复位,仅有6例留有Ⅰ～Ⅱ度滑脱。术后第4个月起至末次随访,全部病例症状无复发,固定节段的椎体间复位无丢失,椎间高度无丢失。全部病例椎弓根螺钉及cage位置良好,无椎弓根螺钉松动、断钉、断棒,无cage塌陷、松动、移位。结论采用经后路椎间融合器结合椎弓根内固定能使腰椎滑脱症状改善明显,复位满意,固定牢靠,并发症少,临床效果满意。

Combined intervertebral fusion device with pedicle screw internal fixation for the treatment of twenty-nine patients with lumbar spondylolisthesis

Objective To evaluate the clinical effect of using posterior intervertebral fusion device and pedicle screw internal fixation to treat lumbar spondylolisthesis.Methods Among twenty-nine patients with lumbar spondylolisthesis,twelve cases were Ⅰ° spondylolisthesis,fourteen cases were Ⅱ° spondylolisthesis,three cases were Ⅲ° spondylolisthesis,ten cases were degenerative lumbar spondylolisthesis,nineteen cases were Isthmic spondylolisthesis.Twenty-nine cases were treated with posterior intervertebral fusion device and pedicle screw internal fixation,clinical symptom,physical sign and imageology data were observed pre-and post-operation.All patients were followed up for 24 ～ 41 months(averaged 38 months).Results In the first three months after operation,twenty cases were excellent,eight cases were good,one cases was fair,the satisfactory rate was 96.6%.The lumbar in twenty-three cases were anatomical reposition,six cases still were Ⅰ° spondylolisthesis.In the period of follow-up visit from the fourth month to the last,and no recurrence was observed in all cases.No pedicle screw was loose or broken.No cage was loose,crashed or moved.Conclusion Using posterior intervertebral fusion device and pedicle screw internal fixation to treat lumbar spondylolisthesis can obtain improving,satisfactory reposition,strong fixation,less complication and satisfactory clinical effect.