成人腰椎多节段峡部裂性滑脱的手术治疗

【目的】评估多节段腰椎峡部裂的手术疗效。【方法】采用后路经椎弓根内固定，椎板切除减压，椎体间植骨融合治疗成人多节段峡部裂性腰椎滑脱患者9例。【结果】9例均获得一定程度的复位。术后随访12～48个月，平均随访30个月，术后1年X线复查显示融合率100％，根据JOA评分以及Oswestry功能障碍指数评价手术疗效，所有患者均对术后疗效满意。【结论】腰椎峡部崩裂所引起的多节段腰椎滑脱常需手术治疗，手术主要目的是有效融合及坚强内固定重建脊柱稳定性，神经减压、适当复位，手术治疗疗效显著、可靠。

Surgical Treatment of Adult Multi-segment Isthmic Lumbar Spondylolisthesis

Objective] To evaluate the clinical surgical outcome of adult multi-segment isthmic lumbar spondylolisthesis. Methods]Nine cases were treated with posterior lumbar trans-pedicle instrumentation and decompression of total laminectomy, bone graft and fusion through intervertebral body. Results] All patients were followed up from 6 months to 48 months at average of 30 months. The fusion rate was 100% on plain radiographs. The Japanese Orthopaedic Association （JOA） scores and the Oswestry index were used to assess the clinical outcome. All patients were satisfied with the postoperative outcomes. Conclusion] Operation is necessary to adult multi-segment isthmic lumbar spondylolisthesis. The key is sufficient decompression and reduction, effective bone graft and fusion and reliable pedicle screw fixation. It can successfully provide interbody fusion and clinical results.