峡部不连伴低度滑脱的手术治疗

峡部不连伴低度滑脱的治疗方法选择一直存在较大的争议,到目前为止,标准的治疗方法尚未确定。峡部直接修复术很适宜有症状但未合并椎间盘退变者。研究已表明原位植骨融合术不用器械固定可获得较好的临床效果,融合率较高,没有滑脱进展的危险性,是一种安全、有效的手术方法。单平面减压联合原位植骨融合适用于下腰痛伴双侧或单侧腿部根性疼痛者。前路椎体间融合适用于伴有椎间盘退变者。不管采用何种手术方式,只有获得牢固融合、降低椎体间病理性活动才能防止滑脱的发展,取得满意的治疗效果。

Operative Treatment of Spondylolysis with Low-grade Spondylolisthesis

Spondylolysis with low-grade spondylolisthesis is challenging in view of the large variety of treatment method options.So far standardized treatment has still not been established.Direct pars repair is very suited for younger,symptomatic patients without concomitant degenerative disc disease.In situ fusion without instrumentation shows good clinical results with high fusion rates and without increased risk of slip progression.It is an effective and safe operative method.A single-plane decompression combining in situ fusion is suited for patients who present low back pain accompanied with either unilateral or bilateral radicular leg pain.Anterior lumber interbody fusion is suited for patients accompanied with degenerative disc disease.Regardless of the surgical procedure performed,only the ability to obtain a solid fusion and thereby reduce pathologic motion of the interbody can lower the risk of the progression and obtain a satisfactory outcome.