保留棘突韧带复合体的双侧椎板开窗联合椎间融合治疗腰椎滑脱症

目的:观察保留棘突韧带复合体的双侧椎板开窗、复位、椎间融合内固定手术治疗腰椎滑脱症的疗效.方法:选取31例患有腰椎滑脱症病人,随机分成保留棘突韧带复合体组(A组)14例和全椎板切除组(B组)17例,分别行双侧椎板开窗减压、椎弓根钉固定复位椎体间融合手术和全椎板切除减压、复位椎体间融合手术.对2组病人手术前后日本骨科协会评估治疗(JOA)评分变化值、手术时间、术中出血量、术后引流量、术后3个月融合率进行比较.结果:A组手术前后JOA评分变化值显著高于B组(P<0.05),术后引流量显著低于B组(P<0.05).2组术后3个月融合率、手术时间及术中出血量差异无统计学意义(P>0.05).结论:保留棘突韧带复合体的双侧椎板开窗椎间融合手术是治疗腰椎滑脱症的一种满意手术方法.

Effect of bilateral vertebral lamina fenestration combined with interbody fusion under retaining spinous process and ligament in the treatment of spondylolisthesis

Objective:To investigate the efficacy of the bilateral vertebral lamina fenestration,reseting combined with interbody fusion under retaining spinous process and ligament complex in the treatment of lumber spondylolisthesis. Methods:Thirty-one patients with lumbar spondylolisthesis were randomly divided into the retaining spinous process(group A) and total laminectomy group(group B). The A group were treated with bilateral vertebral lamina fenestration,decompress combined with interbody fusion,and the group B were treated with total laminectomy decompress combined with interbody fusion. The JOA scores before and after operation,operation time, blood loss,postoperative drainage and fusion rate after 3 months of operation between two groups were compared. Results:The change of JOA score between before and after operation in group A was significantly higher than that in group B(P<0. 05). The postoperative drainage volume in group A was significantly lower than that in group B(P<0. 05). The differences of the fusion rate after 3 months of operation,operation time and peroperative bleeding between two groups were not statistically significant(P>0. 05). Conclusions:Under remaining spinous process and ligament complex,the treatment of lumber spondylolisthesis with bilateral vertebral lamina fenestration combined with interbody fusion is a good method.