后路椎间、峡部及后外侧植骨加椎弓根钉内固定术治疗峡部裂性腰椎滑脱症

目的：探讨应用后路椎间、峡部及后外侧植骨加椎弓根钉内固定术治疗峡部裂性腰椎滑脱症的疗效。方法：采用松质骨颗粒椎间植骨、峡部及后外侧植骨加椎弓根钉系统复位固定治疗峡部裂性腰椎滑脱症31例，术后采用侯树勋等制定的疗效评定标准及融合率来评价临床疗效。结果：31例术后获随访，随访时间10—18个月，平均13．4个月。本组患者术后无神经损伤和切口感染，所有滑脱节段全部融合，无椎弓根螺钉松脱、断裂及神经并发症。按侯树勋的疗效评定标准评价结果为优20例、良8例、可3例、差0例。结论：在椎弓根钉内固定系统复位固定的基础上进行椎间植骨椎等制定间融合率高，峡部植骨及后外侧植骨融合后可增加脊柱的稳定性，疗效好，值得临床推广。

Treatment of isthmic spondylolisthesis by using intervertebral,isthmic and posterolateral bone grafting plus posterior pedicle screw fixation

Objective To study the clinical therapeutic efficacy of posterior vertebral pedicle screw fixation plus intervertebral,isthmic and posterolateral bone grafting for lumbar isthmic spondylolisthesis.Method There were 31 lumbar isthmic spondylolisthesis cases were treated by granule cancellous bone grafting and vertebral pedicle screw fixation.All of 31 cases were evaluated by standard of Hou Shu-xun and fusion rate after operation.Results Total 31 patients were followed up for 10 to 18 months after the operation,with an average time of 13.4 months.No nerve damage or incision infection.The solid fusion was obtained by observing dynamic radiography.No screw loosening or breakage.No nerve complications.All cases were evaluated by standard of Hou Shu-xun: 20 cases of excellent,8 of better,3 of improved and 0 of poor effect.Conclusion On the basis of vertebral pedicle screw fixation,using intervertebral bone grafting could increase the rate of fusion,and using isthmic and posterolateral bone grafting could add spine stability,with good efficacy.