单纯性腰椎椎弓根狭部裂的手术治疗

目的对单纯性腰椎椎弓根狭部裂手术治疗适应证，手术方式的选择进行探讨。方法16例无椎体滑脱的单纯性椎弓根狭部裂行手术治疗。根据患者的年龄、椎间盘退变及椎体稳定性情况，分别行椎弓根峡部局部减压植骨＋椎弓根钉钩系统内固定，或后路减压椎弓根钉内固定＋后路（或前路）椎体间植骨治疗。并对术后临床症状的改善，椎体的稳定性进行观察。结果所有病例术后症状均有明显的改善。术后3个月评价12例为优，4例为良，有效率100％。腰腿痛JOA评分平均提高8分。随访6～14个月，脊柱稳定性良好。结论对有临床症状的单纯性椎弓根狭部裂行手术治疗有良好的临床效果，手术方式的选择应根据患者的情况综合考虑。

Surgical therapy of lumbar spondylolysis without spondylolisthesis

Objective To investigate the indications and approaches of surgical therapy for lumbar spondylolysis without spondylolisthesis. Methods Sixteen cases of lumbar spondylolysis without spondylolisthesis underwent local decompression and bone graft with pedicle screws and laminar hooks fixation, or posterior decompression and pedicle screws fixation with posterior （or anterior） intervertebral approach bone graft. Different surgical procedures were decided in consideration of patients＇age, status of intervertebral discs degradation and vertebral stability. Postoperative symptoms and vertebral stability were observed. Results Postoperative symptoms were relieved in all cases. Three months after operation, 12 cases had excellent outcomes,4 cases had fine outcomes and the effective ratio was 100%. JOA scores were elevated by 8 point. Vertebral stability was fine during the 6 - 14 months＇ follow - up. Conclusion There are good clinical effects in surgical therapy of spondylolysis without spondylolisthesis, and appropriate procedures should be selected based on patients＂ integrated situation.