后路复位椎弓根钉内固定联合椎间融合器融合术治疗腰椎滑脱症的临床研究

目的探讨后路复位椎弓根钉内固定联合椎间融合器融合术治疗腰椎滑脱症的疗效。方法回顾性分析2010年1月～2013年8月我院应用后路复位椎弓根钉内固定联合椎间融合器融合术治疗腰椎滑脱症36例的临床资料。结果本组36例患者手术时间120～190min，平均150min。参考Prolo腰椎术后功能评定标准：治愈11例，有效23例，无效2例，总有效94．4％；住院时间10～21d，平均15d。36例腰椎滑脱患者术后滑脱率较术前显著降低（t=34．235，P〈0．01），椎间隙高度明显提高（t=4．237，P〈0．01），滑脱角明显缩小（t=17．346，P〈0．01）。VAS评分较术前明显降低（t=3．264，P〈0．01），JOA评分明显升高（t=6．823，P〈0．05）。随访期间结果显示，36例腰椎滑脱症患者的滑脱率、椎间隙高度、滑脱角、JOA分与术后比较，差异不显著（t=0．235、0．573、0．873、0．467，P〉0．05）。结论后路复位椎弓根钉内固定联合椎间融合器融合术治疗腰椎滑脱症是一种理想的手术方法，并发症少．疗效确切，值得推广和应用。

Clinical study of posterior transpedicular device fusion for lumbar spondylolisthesis internal fixation combined with interbody fusion

Objective To investigate the therapeutic effect of posterior transpedicular device fusion for lumbar spondy- lolisthesis internal fixation combined with interbody fusion. Methods Retrospective analyzed clinical data of 36 cases with fusion for lumbar spondylolisthesis internal fixation combined with interbody fusion by posterior transpedicular from 2010 January to August 2013 in our hospital. Results Operation time of 36 cases of patients was 120 to 190 min, average 150 min. Reference Prolo postoperative lumbar function evaluation standard： 11 cases were cured,23 cases were effective, 2 cases were ineffective, the total effective rate was 94.4%. Hospital stay time was 10-21 d, average 15 d. 36 cases of lumbar spondylolisthesis patients postoperative slippage rate decreased significantly （t=34.235 ,P〈0.01 ）, the height of intervertebral space increased significantly （t=4.237,P〈0.01）,slip angle was significantly reduced （t=17.346, P〈0.01 ）. VAS score was significantly lower than that before operation （t=3.264, P〈0.01 ）, JOA score increased signif- icantly （t=6.823 ,P〈0.05）. During the follow-up results showed 36 cases of spondylolisthesis, lumbar spondylolisthesis rate of patients, the height of intervertebral space, slip angle, JOA after operation compared with before treatment, the difference was not significant （t=0.235,0.573,0.873,0.467, P〉0.05）. Conclusion Posterior transpedicular screw internal fixation combined with interbody fusion for spondylolisthesis treated with curative effect is exact.