腰椎后路植骨并椎弓根钉棒内固定术治疗症状性双节段峡部裂

目的：探讨腰椎后路植骨并椎弓根钉棒系统内固定治疗症状性双节段腰椎峡部裂的临床疗效。方法回顾性分析腰椎后路手术治疗的12例有临床症状的双节段腰椎峡部裂患者，采用JOA腰痛评分标准、Smiley-Webster功能评分法、Oswestry功能障碍指数、Taillard指数综合、Lenke脊柱植骨融合评价标准评定术后疗效。结果术后JOA腰痛评分、Oswestry功能障碍指数、Taillard指数均较术前明显改善，差异具有统计学意义（P〈0.05）。 Smiley-Webster功能评分结果：优8例，良3例，可1例。Lenke评价植骨融合结果：A级20个节段， B级4个节段。结论腰椎后路峡部植骨或椎体间融合结合椎弓根钉棒系统内固定术是治疗症状性双节段峡部裂的有效方法，能够取得满意的疗效。

Posterior bone grafting and pedicle screw-rod system fixation for the treatment of symptomatic double-segmental isthmic spondylolisis

Objective To explore the clinical effect of symptomatic double-segmental lumbar isthmic spondylolisis treated by posterior approach bone grafting and pedicle screw-rod system fixation. Methods Retrospectively analyzed clinical data of 12 patients with symptomatic double-segmental lumbar isthmic spondylolisis. All patients were treated by means of posterior approach surgery. The Japanese Orthopedic Association（JOA） score, Smiley-Webster function score, Oswestry disability index, Taillard index and Lenke spine grafting efficacy were used to evaluate the clinical outcomes. Results The postoperative JOA score, Oswestry disability index and Taillard index were significantly improved compared with preoperative, and the difference was statistically significant（P〈0.05）. The Smiley-Webster function score： excellent in 8 cases, good in 3 cases, fine in 1 case. The bone fusion was grade A in 20 segments and grade B in 4 segments assessed by Lenke spine grafting efficacy.Conclusion Posterior lumbar isthmic bone grafting or interbody fusion combined with pedicle screw-rod system fixation is an effective method in the treatment of symptomatic double-segmental isthmic spondylolysis. The clinical effect are satisfactory.