Cage植骨联合椎弓根螺钉内固定融合治疗腰椎滑脱的疗效观察

目的研究不同入路Cage植骨联合椎弓根螺钉内固定融合治疗腰椎滑脱的临床疗效。方法将2011年1月至2012年12月我院收治的120例腰椎滑脱患者按手术方式分为前路椎体间植骨融合术(ALIF)组和后外侧植骨融合术(PLF)组、经后路椎体间植骨融合术(PLIF)组,每组40例,观察手术相关指标及远期机体功能情况。结果 PLIF组患者的手术时间为(82.3±12.1)h,术中出血量为(60.3±9.5)mL,术后下床活动时间为(5.5±0.7)d,NRS评分为(1.5±0.2)分,术后3、6、9、12个月后的ODI评分分别为(24.1±3.4)分、(19.4±3.1)分、(13.5±2.5)分、(9.8±1.6)分,各项指标均明显低于ALIF组和PLF组,PLIF组椎间隙高度(9.3±1.2)mm,明显大于ALIF组和PLF组(P0.05)。结论经后路椎间植骨融合术能够减小手术创伤,促进术后恢复,改善远期机体功能,在腰椎滑脱的治疗中具有积极价值。

Cage bone graft combined with pedicle screw fixation fusion in treatment of lumbar spondylolisthesis

Objective To study the effect of different approaches of Cage bone graft combined with pedicle screw fixation fusion in trea- ting lumbar spondylolisthesis. Methods From January 2011 to December 2012,120 patients with lumbar spondylolisthesis in our hospital were randomly divided into anterior lumbar interbody fusion （ALIF） group（ n = 40 ） , postero lateral fusion （PLF） group （n = 40） and posteri- or lunbar interbody fusion （PLIF） group（n =40）. The related index and body＇ s function were observed. Results In PLIF group,the opera- tion time was（ 82.3 ± 12.1 ） h,intraoperative bleeding volume was （ 60.3 ± 9.5 ） mL, postoperative ambulation time was （ 5.5±0. 7 ） d, NRS score was （ 1.5 ± 0.2 ）, ODI score 3,6,9,12 months after operation were respectively （ 24. 1 ± 3.4 ）, （ 19.4 ±3.1 ）, （ 13.5 ± 2.5 ）, （9.8± 1.6） ,which was significantly lower than ALIF group and PLF group;the intervertebral height（9.3 ±1.2） mm were significantly high- er than those of ALIF group and PLF group. Conclusion PLIF has positive clinical value in treating lumbar spondylolisthesis as it can re- duce the operation wound, promote postoperative recovery, and improve the long-term function of body.