摘要
目的观察应用椎弓根螺钉内固定技术，并分别结合侧后方融合（PLF）和经后路椎体间融合（PLIF）两种方法治疗老年人腰椎滑脱症的临床效果。方法应用枢法模公司生产的TSRH-3D腰椎后路内固定系统治疗30例腰椎滑脱症患者，其中14例患者实施TSRH-3D内固定加侧后方植骨融合（PTJF）；16例患者行TSRH-3D内固定加经后路椎体间融合（PLIF），进行术前术后功能、症状评分。结果30例患者均达到良好的融合效果；实施PLF患者，Prolo功能和症状评分分别为1．25和1．64；术前腰椎滑脱角为48．6％，术后恢复至17．5％。实施PLIF患者，Prolo功能和症状评分分别为1．18和1．39；术前腰椎滑脱角为44．2％，术后恢复至20．3％。结论治疗成人腰椎滑脱症，应用TSRH-3D腰椎后路内固定系统可以获得牢固稳定，在保持腰椎术后功能恢复方面，PLIF优于PLF，但临床结果尚无明显差异。
Objective Clinical and radiographic results in 30 consecutive patients undergoing posterior lumbar fixation and posterior facet joint or posterior interbody fusion for Meyerding Grade Ⅱ/Ⅲ spondylolisthesis were assessed： （1） to address the suitability of a dynamic stabilization; and （2） to investigate whether there are differences in terms of clinical and functional results between these two types of arthrodesis. Methods Fourteen patients underwent posterior interfacet fusion （PLF） and implantation of TSRH-3D system. Posterior lumbar interbody fusion （PLIF） and placement of the same system were performed in 16 patients. Clinical, economic, functional and radiographic data were recorded both pre- and postoperatively. Results The average changes in Prolo Scale of economic and functional scores were 1.25 and 1.64 respectively, in patients undergoing posterior fusion ; the average measured vertebral slippage was 48.6% （range 32% -65% ） preoperatively and 17. 5% （range 15% -25% ） postoperatively. In patients undergoing PLIF, the average changes in economic and functional score were 1.18 and 1.39 respectively, and the average preoperative vertebral slippage was 44. 2% （ range 30% - 55% ） versus 20. 3% （ range 18% -26% ） postoperatively. Conclusion The use of a segmental pedicle screw fixation with TSRH-3D was able to successfully combine the goal of solid fusion with the requirements of nerve root decompression. When these two fusion techniques were compared, PLIF was superior to PLF because of an overall superior reliability and system resistance. But their clinical outcomes did not differ greatly （ P 〉 0. 05 ）.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2009年第25期1779-1782,共4页
National Medical Journal of China
关键词
脊柱融合术
腰椎
减压术
外科
Spinal fusion
Lumbar vertebrae
Decompression, spinal
