椎弓根钉固定椎间植骨融合治疗重度L5滑脱症

目的探讨椎弓根钉固定椎间植骨融合治疗重度k滑脱症的治疗效果。方法对15例重度k滑脱症患者采用行椎板切除减压和髓核摘除，直视下打椎弓根螺钉进行复位内固定，同时行椎间植骨，后外侧关节突和横突间植骨融合，术后卧床休息4～6周后佩戴腰围下床活动。结果随访18—26个月（平均19．6个月），Ⅲ度滑脱10例，获得解剖复位3例，仍有Ⅰ度滑脱7例，椎体复位率达90％，IV度滑脱5例复位率达75％-90％。术后1．5年拍照片示椎体间均有骨性融合，其中RSS固定者螺丝钉折断1例，所有患者腰腿痛症状完全缓解，术后按照邹德威临床疗效综合评分标准评定为优11例，良4例。结论椎弓根钉固定椎间植骨融合治疗重度L5滑脱症效果满意。

Pedicle screw combined with intervertebral bone grafting fusion for severe lumber spondylolisthesis

Objective To evaluate the outcome of pedicle screw combind with intervertebral bone grafting fusion for severe lumbar spondylolisthesis. Methods Fifteen patients with severe seere lumbar spondylolisthesis were treated with the method of laminectomy, resection of nucleus pulposus, installing the pedicle screw fixation, diaplasis, intervertebral,facet joint or intervertebral bone grafting fusion. After 4 -6 weeks of bed rest, patients were allowed to perform with the kummerbund. Results The fallow-up time ranged from 18 to 26 months with average of 19. 6 months,3 of 10 patients of Ⅲ spondylolisthesis obtained completel disaplasis,7 patients remained I spondylolisthesis. The diaplasis rate was 90%. In 5 patients of Ⅳ spondylo]isthesis diaplasis rate was 75% - 90%. After 1.5 years, X-ray showed all the patients had fusion. In one patient with RSS fixation the pedide stew broken. All the patients symptom achieved complete remission. Judged by ZOU De-wei standard, excellent outcome was found in 11 patients, good outcome in 4 patients. Conclusion Pedicle screw combined with intervertebral bone grafting fusion for severe severe lumbar spondylolisthesis has a satisfactory effect.