摘要
目的观察腰椎滑脱症在椎管减压、椎弓根钉复位固定、π式椎间融合手术治疗的临床疗效.方法采用后路手术,行椎管、侧隐窝及神经根管的彻底减压,切除病变椎间盘,利用椎弓根钉复位,行病变椎体间前方植骨,左右椎间融合器融合及椎弓钉内固定术治疗腰椎滑脱症48例.结果36例Ⅰ度滑脱完全复位,10例Ⅱ度滑脱有9例复位,1例Ⅳ度滑脱完全复位,滑脱复位满意率98%.椎体间高度恢复正常.用JOA评分,术前JOA平均评分6.715分,术后JOA平均评分13.343分.术后根据X线片检查,所有患者椎体间π式融合均骨融合;椎间隙高度保持正常,滑脱未复发.术前术后JOA评分平均改善率80.81%.随访18～26个月,JOA评分平均改善率88.74%.结论后路π式椎体间融合治疗腰椎滑脱症,恢复了椎体间高度,扩大了椎体间植骨接触的面积,减少了椎弓根钉的应力,即防止了滑脱矫正度数的丢失,又有利于椎体间的骨融合,同时减少了椎弓根钉的断钉发生率.
Objective To observe the clinical outcome of type π interbody fusion tor treatment lumoar spondylolisthesis.Methods To adopt the posterior approach to lumbar spine, the lumbar spine canal stenosis and root - canal stenosis were treated with decompression for lumbar spondylolisthesis, degenerative discectomy and internal fixation with pedicle screws and rods were applied to recover the position. In the front of interbody bone grafting was done obtained from the osteotomying laminea and spinous process. And the interbody fusion cage and the pedicle screws system were performed. From October of 2000 to October of 2002, we totally accepted to cure 48 cases of lumbar spondylolisthesis with decompression from spine canal stenosis. According to Meyerding classification, 48 cases were classified as 6 cases as Ⅰ degree between L3 and L4 ; 22 cases as Ⅰ degree, 7 cases as Ⅱ degree between L4 and Ls ; 9 cases as Ⅰ degree, 3 eases as Ⅱ degree, 1 case as Ⅳ degree between L5 and S1. Results Degree I slip was 36 cases and to take off to reset completely, degree Ⅱ slip was 10 cases and to take off 98% to reset, degree Ⅳ slip was 1 cases and to take off to reset completely, the high of vertebrae interbody was normal. Using the grade point of JOA, average grade point was 6. 715 cent before operation, while 13.343 cent af- ter operation. All type π interbody fusion was complete. On the basis of X - ray examine after operation, height of vertebrae interbody Stands in normal level, vertebrae sliping did not relapse. The average rate on the improvement of grade point of JOA after operation is 80.81%. With a further visit ranging from 18 months to 26 months, on average 24.3 months, this number reached 88.74%. Conclusion π type interbody fusion of application of lumbar reconstruction in treatment lumbar spondylolisthesis has satisfactory reduction rate and excellent clinical results.
出处
《中国骨与关节损伤杂志》
2005年第8期531-533,共3页
Chinese Journal of Bone and Joint Injury
