通用型脊柱椎弓根内固定系统治疗腰椎滑脱的临床研究

目的 观察自行研制的通用型脊柱内固定系统用于退行性腰椎滑脱患者手术治疗的疗效。方法 16例退行性腰椎滑脱合并椎管狭窄的患者,均接受了通用型脊柱内固定系统手术治疗。其中男10例,女6例。平均年龄58．5岁(42～72岁)。术前Ⅰ度滑脱10例,Ⅱ度滑脱6例,术后定期随访记录患者的症状改善、滑脱复位程度及并发症等情况。结果 16例患者术后平均随访21．2个月(18～24个月),术后即刻及末次随访时X线摄片显示滑脱腰椎均完全复位,于末次随访时15例患者术前临床症状均消失,滑脱复位满意且无丢失,后外侧植骨融合术后及随访过程中未发现与植入物或手术相关的并发症。结论 初步结果显示,通用型脊柱内固定系统用于腰椎滑脱的手术治疗可获得满意的滑椎复位效果和良好临床疗效。

Clinical study on treatment of lumbar degenerative spondylolisthesis by using general spine system

OBJECTIVE: To observe early clinical efficacy of general spine system (GSS) in spondylolisthesis combined with lumbar canal stenosis, lumbar decompression, reduction and bone graft. METHODS: Sixteen patients with degenerative lumbar spondylolisthesis combined with lumbar canal stenosis, 10 male, 6 female, average age 58.5 years (range 42 - 72 years) underwent lumbar decompression, bone graft and internal fixation using GSS. Preoperatively 10 patients had degree I spondylolisthesis and 6 patients had degree II spondylolisthesis. Clinical efficacy, reduction effectiveness and complications were recorded. RESULTS: The 16 patients in this group were followed up postoperatively for an average of 21.2 months (18 - 24 months). At latest follow-up after surgery, preoperative clinical symptoms had disappeared completely in 15 of 16 patients, and low back pain relief was seen in 15 patients. Average duration of surgery was 170 min (120 - 270 min), and average blood loss was 375 ml (100 - 800 ml). X-ray results showed complete reduction for all spondylolisthesis patients, and results remained good in follow-up. Dura mater tearing, pedical fracture, nerve injury and other surgical complication did not occur. Screw breakage, screw loosening and instrument loosening at the screw-rod juncture were not observed after surgery or in follow-up. CONCLUSION: GSS provides good reduction for spondylolisthesis, and shows good early clinical efficacy.