摘要
【摘要】目的回顾性总结分析腰椎椎间撑开复位、椎间融合内固定术治疗成人峡部裂型腰椎滑脱症。方法回顾总结2006年lO月至2011年11月，收治的采用腰椎椎间隙撑开复位、椎间融合内固定术治疗的78例成人峡部裂型腰椎滑脱症患者的临床资料。男42例，女36例，年龄41。69岁，平均为52．4岁。病程3个月至7年，平均38个月。病变节段：L3峡部裂3例，L4峡部裂28例，k峡部裂47例。按Meyerding分度：I度滑脱25例，II度滑脱47例，III度滑脱6例，滑移程度为（39．3±10．9）％。术后应用Oswestry功能障碍指数（ODI）、VAS评分及影像学检查对临床疗效进行评价。结果手术平均时间118min，术中出血平均540ml。随访24～83个月，平均41个月。VAS评分术前为6．7±1．5、末次随访为1．7±1．3；ODI指数术前为（60．7±9．8）％、末次随访为（24．1±4．9）％；以上指标末次随访与术前比较差异均有统计学意义（P〈0．05）。滑移程度末次随访为（9．8±4．1）％，滑脱复位率为75．1％，2年融合率为97．4％。结论应用椎间隙撑开复位、椎间融合内固定治疗成人峡部裂型腰椎滑脱症，疗效确实，操作简单、安全，并发症少。
Objective To retrospectively explore the clinical outcomes of intervertebral space distraction reduction and posterior lumbar interbody fusion with transpedicular screw/rod fixation in the treatment of adult isthmic spondylolisthesis. Methods From October 2006 to November 2011, 78 patients with adult isthrnic spondylolisthesis underwent the treatment of intervertebral space distraction reduction and posterior lumbar interbody fusion with transpedicular screw/rod fixation, and their clinical data were retrospectively analyzed. There were 42 males and 36 females, whose average age was 52.4 years old （ range; 41-69 years ）. The average course time was 38 months （ range; 3-84 months ）. The levels of lumbar spondylolisthesis was L3 in 3 cases, L4 in 28 cases and L5 in 47 cases. According to the Meyerding classification, 25 cases were classified as degree I, 47 cases as degree II, and 6 cases as degree IlI. The average slippage degree was （ 39.3±10.9 ） %. The Visual Analogue Scale （ VAS ） and Oswestry Disability Index （ ODI ） were used to assess the clinical outcomes, and the imaging examination was also performed. Results The average surgical time was 118 minutes, and the average intraoperative blood loss was 340ml. All patients were followed up for an average period of 41 months （ range; 24-83 months ）. The VAS scores were 6.7±1.5 points and 1.7±1.3 points preoperatively and in the latest follow-up respectively, and the differences were statistically significant （ P〈0.05 ）. The ODI scores were （ 60.7±9.8 ） % and （ 24.1±4.9 ） % preoperatively and in the latest follow-up respectively, and the differences were statistically significant （ P〈0.05 ）. The slippage degree was （ 9.8±4.1 ） % in the latest follow-up, with the reduction rate of 75.1% and the fusion rate of 97.4% at the 2nd year after the operation. Conclusions Intervertebral space distraction reduction and posterior lumbar interbody fusion with transpedicular screw/rod fixation are safe in the treatment of adult isthmic spondylolisthesis, with the advantages of excellent clinical results, easy manipulation and fewer complications.
出处
《中国骨与关节杂志》
CAS
2014年第1期10-14,共5页
Chinese Journal of Bone and Joint
关键词
脊椎滑脱
骨牵引复位法
脊柱融合术
腰椎
Spondylolysis
Skeletal tracting reposition
Spinal fusion
Lumbar vertebrae
