椎弓根螺钉复位固定加不同的植骨方法 治疗腰椎滑脱的疗效比较

目的探讨不同类型腰椎滑脱的手术治疗方法、疗效及优缺点。方法应用后路椎弓根螺钉加不同的植骨方法共治疗腰椎滑脱患者50例，按植骨方法不同，随机分为A、B、C三组，比较术后疗效、复位率、植骨融合率及复位丢失率等。结果门诊随访6个月～3年，结果显示44例基本上达解剖复位，优37例，良7例，优良率达88．0％，后外侧植骨16例中有6例复位丢失，其中1例发生椎弓根螺钉断裂。结论对于不同类型的腰椎滑脱可采用经椎弓根螺钉复位固定加不同类型的植骨方法，其中以椎间植骨及椎间cage植骨融合率较高，复位无丢失，是一种较好的治疗腰椎滑脱的方法。

The Selection on the Surgical Management of Lumbar Spondylolisthesis

Objective To explore the resional methods for the treatment of differrent types of lumbar spondylolisthesis,and compare their therapeutical effects and indications. Methods Posterior pedical screw fixciation combined with various bone fusion was used to treat 50 cases with lumbar spondylolisthesis,and their therapeutical effects and the rates of reduction,hight recovery of disc space,bone graft fusion,and loss of reduction were compared.Results 44 cases were reduced anatomically during the follow-up,the total succcess rate was 88.0%;37 cases with lumbar interbody fusion and cage fusion had good bone graft fusion,nomal disspace and no loss of reduction;6 cases with posterlateral bone graft fusion had loss of reduction to a certain degree;1 case had perdical scews broken.Conclusion According to differrent types of spondylolisthesis using perdical screws combined with differrent ways of bone graft fusion,the patients with posterior pedical screws combined with fusion cage or interbody fusion got good bone graft fusion and no loss of reduction,which is a good method for treatment of lumbar spondylolisthesis.