USS复位融合治疗成人疼痛性峡部裂腰椎滑脱

目的探讨USS系统椎体间撑开复位、固定、椎间融合治疗成人腰腿痛性峡部裂腰椎滑脱的安全性与临床疗效。方法回顾性分析USS系统撑开复位固定椎间融合术治疗的19例峡部裂腰椎滑脱患者。手术指证为保守治疗无效的长期腰腿痛患者。随访12～48个月,定期摄X线片。比较手术前后VAS及工作情况、体育活动、止痛药的服用量。结果临床效果评价：优11例,良8例,差或无效0例。无神经并发症。平均腰痛VAS：术前7.3;术后1.6（变化范围0～3）。平均腿痛VAS：术前8;术后1（变化范围0～4）。平均随访28个月（12～48个月）后X线显示,所有的病例均在术后12～18个月获得骨性融合。其中15例在术后1年后即融合。滑移情况：17例术后滑移〈10%,2例〈20%。无内固定失败。结论USS系统校正腰椎矢状序列治疗成人峡部裂腰椎滑脱,疗效满意,操作简便。

Therapeutic effec of USS slip reduction and fusion on painful isthmic spondylolisthesis in adults

Objective To evaluate the safety and clinical efficiency of operative instrumented slip reduction in the treatment of 19 cases of isthmic spondylolisthesis accompanied by low back and leg pain.Methods The 19 patients underwent posterior decompressive,pedicle screw fixation,slip reduction by universal spine system（USS）,and posterior lumbar interbody fusion.The indications for surgery were long-standing low back and leg pain that had not responded to nonoperative management.The patients were followed up for 12~48 months.The efficiency parameters included the visual analog scale（VAS） and work status,participation in sport activities and dosage of pain-killer.Results The surgical efficiency was excellent in 11 patients,and good in 8 patients,and no patient was unchanged or poor in the postoperative status.No neurologic complications were found.The mean preoperative VAS for back pain of 7.3 was reduced to 1.6 after surgery（range： 0 to 3）.The mean preoperative VAS for leg pain of 8 was decreased to 1 after surgery（range： 0 to 4）.All the patients achieved successful radiographic fusion at 12~18 months.No implant fractures or deformities occurred in all patients.Conclusion The correction of the sagittal translation by USS is more excellent and simple,which may contribute to performing slip reduction for isthmic spondylolisthesis in adults.