RF椎弓根系统加后路减压融合治疗腰椎滑脱

目的探讨RF椎弓根系统加后路减压融合治疗腰椎滑脱症的疗效。方法39例腰椎滑脱症患者经保守治疗无效后采用RF-Ⅱ椎弓根螺钉系统进行后路减压融合手术治疗,其中退变性腰椎滑脱22例,峡部裂性腰椎滑脱17例,Ⅰ度滑脱12例,Ⅱ度滑脱18例,Ⅲ度滑脱9例。比较手术前后临床症状及X线片。结果所有患者术后随访均超过6个月。退变性腰椎滑脱及峡部裂性腰椎滑脱患者术后神经功能改善率分别为81.8%和82.3%;脊柱活动改善率分别为86.4%和88.2%;腰背痛改善率分别为86.4%和88.2%;下肢疼痛改善率分别为90.9%和94.1%;椎体复位满意率分别为90.9%和88.2%。出现并发症共6例,其中术中并发症3例,发生率为7.7%;术后并发症3例,发生率为7.7%。结论RF椎弓根螺钉系统能使腰椎滑脱得到较为确实的复位和固定,脊柱融合率高,临床效果满意。

Treatment of Lumbar Spondylolisthesis with Posterior Decompression, Spinal Fusion and RF Pedicle Screw Spinal System

Objective To evaluate the clinical efficacy of lumbar spondylolisthesis treated by laminectomy decompression,vertebral body fusion and RF-Ⅱ pedicle screw spinal system.Methods From February 1999 to December 2003,39 cases of lumbar spondylolisthesis were enrolled in this study.According to Meyerding classification,roentgengram showed that there were 12 cases of gradeⅠ°,18 cases of gradeⅡ°,9 cases of grade Ⅲ°;22 cases of degenerative spondylolisthesis and 17 cases of spondylolysis.All patients were treated with decompression of total laminectomy and bilateral nerve canal,intertransverse process arthrodesis were managed by means of bone chip grafting,interbody fusion was done with RF-Ⅱ pedicle screw spinal system.Results All the patients were followed up over 6months.In the patients with degenerative spondylolisthesis and spondylolysis,the amelioration of nerve function was 81.8% and 82.3% respectively;the improvement of spinal motion was 86.4% and 88.2% respectively;the allevioration of low back pain was 86.4% and 88.2% respectively;the allevioration of leg pain was 90.9% and 94.1% respectively;the mean reduction rate of degenerative spondylolisthesis and spondylolysis was 90.9% and 88.2% respectively.Complications occurred in six cases,in which three cases occurred during operation with the incidence of 7.7%,while the other three occurred after operation with the incidence of 7.7%.Conclusion RF pedicle screw spinal system provide fixation with satisfactory clinical results and relatively high fusion rate.