摘要
[目的]阐述、探讨腰椎后路椎体间融合（posterior lumbar interbody fusion，PLIF）及椎弓根内固定治疗低度腰椎滑脱的疗效及临床体会：[方法]回顾性分析2004年1月～2005年9月收治的53例行腰椎后路减压椎间融合及椎弓根内固定治疗的低度腰椎滑脱患者。分析手术前后的Boxall滑脱率、滑脱角及椎间高度的变化。分析临床疗效及融合率、手术方式、并发症之关系，阐述临床治疗新体会。[结果]53例患者均获得随访，平均随访16个月（9～21个月），49例（92，5％）病人获得椎体间骨性融合。术前与术后的Boxall指数、滑脱角及椎间高度均有显著差异（P〈0．01）。并发症：1例患者发生融合器后移；1例患者发生椎间隙低毒性感染；2例患者发生神经根牵拉伤；1例发生融合器下沉。[结论]腰椎滑脱通过腰椎后路一次完成减压、椎间植骨融合及椎弓根内固定，疗效显著。并发症发生与围手术期密切相关，手术过程因人而异，并发症的发生与手术操作技巧、协调性关系尤为密切。
[ Objective] To approach clinical outcomes and experiences of low-grade spondylolistbesis patients treated with posterior lumbar interbody fusiou （PLIF） and transpedicular instrumentation. [ Method] Consecutive 53 cases suffered from low-grade spondylolisthesis were analyzed retrospectively. All patients were treated by posterior lumbar ioterbody fusion and transpedicular instrumentation. Pre-operative and post-operative Boxall index, angle of slipping, intervertebral height were oberserved in all patients. Curative effects, fusion fate, operation-methold and complications were analyzed in all patients. [ Result] All patients were followed up from 9 to 21 months with an average of 16 months. Forty-nine （92.5%） patients were assessed to bony fusion postoperatively. Comparement about preoperative and postoperative Boxall index, angle of slipping and intervertebral height were observed in all patients. There were great changes in all these indexes （P 〈 0. 01 ）. There were five cases with complication： Telamon migrate back in 1 case, intervertebral space low-toxity infection in 1 case, nerve root traction injury in 2 cases and cage subsidence in 1 patient. [ Conclusion] We can complete decompression, interbody bone-grafting by spacer and transpedicular fixation during one operation-time with one incision by posterior lumbar interbody fusion and transpedicular instrumentations operation for low-grade spondylolisthsis. Its clinial curative-effect are obvious and complication-rate is easy to analysis to patients during perioperative period. Operative-methohl is related to every patient＇s condition. Complications are closely related to operative skills and concordances of operators.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2006年第19期1441-1444,共4页
Orthopedic Journal of China
关键词
腰椎后路椎间融合
内固定
脊柱滑脱
posterior lumbar interbody fusion
instrumentation （fixation）
spondylolisthesis
