短节段弹性内固定治疗腰椎不稳症效果观察

目的探讨弹性内固定治疗短节段腰椎不稳症的应用价值和实际疗效。方法2007年6月-2010年6月采用弹性内固定加椎间CAGE植骨融合治疗短节段腰椎不稳症33例。记录手术时间、失血量、植骨融合时间，随访观察相邻节段退变情况。根据侯树勋的疗效评定标准判定疗效。结果手术时间平均95min；术中出血平均250ml，术后无神经根损伤及脑脊液漏登并发症，随访平均18个月，X线片显示33例骨性融合，平均融合时间5个月，内固定无松动及折断，MRI显示所有的病变节段的相邻节段未出现退变或退变加重。末次随访时疗效评定：优30例，良2例，可1例。结论采用弹性内固定治疗短节段腰椎不稳症，可有效的进行腰椎后路减压融合、促进神经功能恢复，有效防止相邻节段退变。

Short segment and dynamic fixation for treating spinal instability

Objective To discuss the application value and the actual effect of short segment and dynamic fixation for treating spinal instability.Methods 33 case with Spinal Instability betwwen June 2007 and June 2010, Data of dynamic fixationa combined with transpedicular bone implantation for treating spinal instability were retrospectively analyzed, The operation time, blood loss during operation and the fusion of bone graft time were record, Observe ajacent segment degeneration.Results The average surgical time 95 minutes, with the average intraopwertive blood loss of 250 ml,There was no complication such as nerve root injury and cerebrospinal fluid leakage.After a mean follow-up 18 months, The complete fusion of bone graft was observed in the all case in the 5 months postoperative. The ajacent segment no degeneration or aggravating on MRI.At final follow-up, there were 30 excellence, 2 good and 1fair. Conclusion Short segment and dynamic fixation for treating spinal instability, it can prevent the no union after decompression of Lumbar spine ,improve neurological function and to prevent ajacent segment degeneration.