撑开式椎间融合器治疗腰椎滑脱症的临床疗效观察

目的探讨应用撑开式椎问融合器行腰椎后路椎问融合术治疗腰椎滑脱症的临床疗效。方法回顾性分析采用撑开式椎间融合器治疗腰椎滑脱症患者的临床资料。记录手术时间和术中失血量。术后定期随访摄X线片及CT，观察滑脱率及椎间隙高度指数矫正情况，椎间融合情况，并应用奥氏失能指数（ODI）评价腰背部功能改善情况。结果20例患者均顺利完成手术，手术时间100～160（123．3±16．4）min；术中失血量350～600（464．0±78．7）ml。患者随访12～36（24．3±7．3）个月，症状均得到明显改善。随访期间20例患者均获得骨性融合，根据改良Maenab分级标准，优14例，良4例，可2例，优良率为90．0％（18／20）。术后6个月和末次随访ODI评分、滑脱率明显低于术前，末次随访ODI评分明显低于术后6个月，差异有统计学意义（P〈0．05）；术后6个月和末次随访椎间隙高度指数明显高于术前，差异有统计学意义（P〈0．05）；术后6个月与末次随访滑脱复位率比较差异无统计学意义（P〉0．05）。末次随访时，未发生椎间融合器下沉或移位、椎间隙塌陷及椎间隙高度明显丢失等情况。结论应用撑开式椎问融合器治疗腰椎滑脱症具有椎间融合率高、手术并发症少、可重建腰椎正常生物力学性能等优点，短期临床疗效满意。

Clinical effect observation of expandable cage in treatment of lumbar spondylolisthesis

Objective To study the clinical effect of posterior lumbar interbody fusion （PLIF） using expandable cage in treatment of lumbar spondylolisthesis. Methods Twenty patients who underwent PLIF using expandable cage for lumbar spondylolisthesis were retrospectively analyzed. The operative time and transoperative bleeding were recorded. Postoperative regularity follow-up X-ray and CT, the olisthy rate, intervertebral height index and intervertebral fusion were observed. The lumbar function improvement was assessed by Oswestry disability index （ODI）. Results All the patients were successfully operated,the operative time was 100 - 160 （ 123.3 ±16.4） min,transoperative bleeding was 350 - 600 （464.0 ± 78.7） ml. The follow-up time was 12 -36 （24.3 ± 7.3） months, symptoms were significantly improved. During the follow-up duration, 20 patients obtained bony fusion. According to the reforming Macnab grade standard, excellent was in 14 cases, good was in 4 cases, acceptable was in 2 cases, the rate of excellent and good was 90.0% （18/20）. The ODI score and olisthy rate postoperative 6 months and last follow-up were significantly lower than preoperative,and ODI score last follow-up was significantly lower than that postoperative 6 months, there were statistical differences （P 〈 0.05 ）. The intervertebral height index postoperative 6 months and last follow-up were significantly higher than that preoperative,there were statistical differences （P 〈 0.05 ）. There was no statistical difference in olisthv reset rate between nostonerative 6 months and last follow-up （P 〉0.05）. The lasl fnllowed-up,There were no expandahle cage suhsidence or displacement, inlervertehra] space collapse and intervertebral height loss. Conclusions As a new production,expandable cage is an effeclive Iool on treating hunhar spondylolisthesis, it can effectively resture the inlervertebral height and the biological mechanical properties of the lumbar vertebrae. This study indicates that expandable cage is an effect