后路环形融合与后外侧融合治疗腰椎滑脱的比较

【目的】比较后路环形融合后内固定术（PCF）与后外侧融合内固定术（PLF）治疗腰椎滑脱（LSL）的效果。【方法】48例LSL患者中26例行PCF（A组），22例行PLF（B组）。比较两组患者术后的融合率、症状改善情况（JOA评分、VAS评分）以及术前、术后以及随访终末的滑脱角、腰椎前凸角、椎间隙高度。【结果】A组患者融合率为100％，B组融合率为81．82％，两组相比较差异有统计学意义（P〈0．05）。两组术后JOA、VAS评分较术前有明显改善（P〈0．05），但组间比较差异无统计学意义（P〉0．05）。两组术后滑脱角、腰椎前凸角及椎间隙高度均较术前有明显改善（P〈0．05），随访时PCF组滑脱角、椎间隙高度丢失程度明显低于PLF组，差异有统计学意义（P〈0．05）。【结论】两种后路融合术都是治疗LSL的有效术式，PCF联合椎弓根螺钉系统内固定是治疗LSL的一种可靠方法，能够提高脊柱的融合率并维持良好的椎间隙高度和形态及腰椎生理性前凸，特别是对中重度LSL患者，具有一定的优越性，应作为首选的手术方法。

Comparison Between Posterior Circumferential Fusion(PCF)and Postlateral Fusion(PLF) in the Treatment of Lumbar Spondylolisthesis

Objective] To explore the effects of posterior circumferential fusion（PCF）versus postlateral fusion（PLF） for the treatment of lumbar spondyloIisthesis（LSL） . Methods] Forty-eight patients with turn bar spondylolisthesis undergoing posterior fusion procedure were divided into two groups. Among them, 26 patients（PCF group） were treated by posterior circumferential fusion assisted with internal fixation, and the other 22 patients（PLF group） were treated by posterolateral fusion supplemented with internal fixation. The fusion rate, JOA score and VAS score after operation, slippage angle, lumbar lordosis angle, height of intervertebral body before and after operation and at the end of follow up were compared between two groups. Results]The fusion rate was 100% in PCF group and 81.82% in PLF group, and there was significant different between two groups（ P 〈0.05）. The JOA score and VAS score were significantly improved postoperatively in two groups（ P 〈0.05）. The slippage angle, lumbar lordosis angle and height of intervertebral body were also significantly improved postoperatively in two groups（ P 〈0.05）, but the improvement of slippage angle and height of intervertebral body could not be maintained effectively in PLF group. Conclusion]PCF combined with pedicle screw system fixation is a reasonable option in treating LSL. It can improve the fusion rate of the spine and maintain good intervertebral space and good lordosis of the lumbar spine. Specially for middle and severe LSL, it has superiority, so it should be the first choice.