摘要
目的 :探讨重度腰椎滑脱病人前后路一期手术的临床疗效及手术适应证。方法 :采用前方椎体复位、植骨、内固定 ;然后进行后路减压。术后平均卧床 3个月 ,下地后腰部支具保护半年。结果 :平均随访 40个月 ,10例骨性融合 ,无矫正丢失 ;1例再滑脱约Ⅱ度 ,神经症状较前加重。 11例中 3例持续腰僵并残留双小腿外侧麻木 ,肋力由Ⅲ级恢复到Ⅳ级。结论 :该手术具有一期解剖复位、消除症状、稳定脊柱的优点 ,对伴骨质疏松及再次手术病人应有坚强内固定、充裕的植骨和足够的卧床时间、必要时辅以外固定是达到骨性融合的基本条件。
Objective:To investigate the clinical effect and operation indications of severe lumbar spondylolisthesis with anterior and posterior once operation.Methods:11 patients were operated first anterior reduction,autograft and internal fixation through exoperitoneum,then posterior laminectomy for complete decompression of the dual nerve roots.The average patients had lain in bed for 3 months after operations and after standing the lumbar had been protected with a holder for half a year.Results:After averaged 40 months'follow up,bone fusion was identified by X ray in 10 patients without loss of correction;one displaced by Ⅱ° or so and the damage of the neurological function is heavier;3 of 11 had continuous lumbar stiff and were numb in the exterior of double lower legs and the muscle force was recovered from Ⅲto Ⅳ.Conclusion:The operation have advantages such as anatomic reduction,relief of pain symptoms and lumbar stabilization.But to osteoporosis or reoperation,it is important for bone fusion to firm internal fixation,abundant autograft and sufficient bed time.The key of the success is extra fixation.Pay attention to the indication of the operation.
出处
《中国矫形外科杂志》
CAS
CSCD
2002年第9期877-878,共2页
Orthopedic Journal of China
关键词
腰椎脱位
外科手术
治疗
Lumbar vertebrae
Dislocation
Operation
