椎弓根内固定系统联合椎问融合器治疗峡部不连性腰椎滑脱症

目的探讨椎弓根内固定系统联合椎间融合器治疗峡部不连性腰椎滑脱症的疗效。方法自2008年1月-2012年1月本院收治峡部不连性腰椎滑脱症45例，所有患者均行椎弓根内固定系统复位滑脱，椎间融合器行椎间植骨融合固定。记录患者的手术情况，使用日本骨科学会腰痛评分标准（JOA评分，）及Oswestry功能障碍指数（OOI）分别对患者治疗前后躯体功能及疼痛状况进行评价。随访观察远期疗效。结果平均手术时间（217-95）min（165-291）min，术中平均出血量（813-307）mL（550～1250mL）。术后未发现脑脊液漏或脊神经根损伤等。随访1-5年，平均26个月。治疗后患者功能障碍指数001（25．7％±4．71％）显著低于治疗前（59．1±10．2％），P〈0．001；JOA评分显著升高（25．9±2．1）分vs（15．2±1．3）分，（P〈0．001）。根据NaKai评分标准，优30例，良8例，可7例，优良率为84．44％。无滑脱复发、内固定松动及断钉发生。结论椎弓根内固定系统加椎间融合器治疗腰椎滑脱症手术安全、有效；能显著改善患者躯体功能，降低患者疼痛疼痛状况；术后优良率高、并发症少。

Pedicle screw system and interbody fusion in the treatment of spondylolysis lumbar spondylolisthesis

Objective To investigate the effect of the pedicle screw system combined interbody fusion in the treatment of spondy- lolysis spondylolisthesis herniation. Methods From January 2008 to January 2012, 45 cases with spondylolysis lumbar spondylolis-： thesis in our hospital received pedicle screw system combined interbody fusion treament. Record the patient＇s surgery situation and use the Japanese Orthopaedic Association score of low back pain （JOA score） and Oswestry Disability Index （ODI）, respectively, to evaluate the physical function and pain of the patients before and after treatment.Follow up and study the long-term effect Results The mean operative time was （217 ± 95）min （165 ± 291 minutes） and mean intraoperative blood loss was（81±307）mL （550-1250） mL. Cerebrospinal fluid leakage or spinal nerve root injury was not found after the surgery. All patients were followed up 1 to 5 years, the average time was 26 months. After treatment, the ODI （25.7%±4.71%） was significantly lower than before treatment （59.1%± 10.2%, P〈0.001）, while JOA score was significantly higher （25.9±＋ 2.1） minutes vs （15.2±1.3）minutes, P〈0.001）. Ac- cording NaKai score, excellent were in 30 cases, good in 8 cases, 7 cases, good rate of 84.44%. No slippage recurrence fixation loosening and breakage occurred. Conclution Pedicle screw system and interbody fusion for the treatment of spondylolysis spondy- lolisthesis is safe and effective. It can significantly improve patients＂ physical function and reduce pain in with postoperative excel- lent rate and fewer complications.