螺纹异体骨椎间融合器加内固定治疗腰椎滑脱

Treatment of lumbar spondylolisthesis with spinal bone allograft interbody fusion cage and internal fixation

目的 观察螺纹异体骨椎间融合器 (AIFC)加经椎弓根内固定器治疗腰椎滑脱的临床效果。方法 对 17例腰椎滑脱患者实施后路椎板减压、AIFC椎间融合及椎弓根螺钉系统内固定 ,其中Ⅰ～Ⅱ度滑脱 10例 ,Ⅱ～Ⅲ度滑脱 7例。手术共植入AIFC 2 7个 ,其中 1个间隙植入 2个 8例、植入 1个 7例 ,同时 2个间隙各植入1个 2例。结果 术后平均随访 2 1个月。临床疗效 :优 14例 ,良 2例 ,可 1例 ,优良率 16 / 17。X线动态观察 :术后 3～ 4个月手术撑开的椎间隙高度有 1～ 2mm的丢失 ,椎间隙感染和断钉各 1例 ,AIFC无移位、成角畸形 ,全部骨性愈合。结论 AIFC具有足够支撑、抗滑移能力 ,椎间融合率高 ;经椎弓根内固定系统可进一步增加椎体即时稳定 。

Objective To investigate the effect of spinal bone allograft interbody fusion cage (AIFC) and pedicle screw systems for lumbar spodylolisthesis. Methods 17 cases of lumbar spondylolisthesis were treated with posterior decompression, AIFC and pedicle screw systems fixation. 27 AIFC were implanted, of which 2 AIFC were implanted in 1 intervertebral space for 8 cases, 1 AIFC in 1 space for 7 and 1 AIFC in 2 space respectively for 2. Results In an average of 21 months (range 3～48 months) follow-up, 14 patients had excellent results, 2 good and 1 fair in clinical evaluation. The excellent and good rate was 16/17. All segments were confirmed to be solid fused without dislodgement or angular deformities by constant X-ray examination and there was 1～2 mm loss in height of supported intervertebral space at 3～4 months after operation. Pedicle screw breakage and infection were found in 1 case respectively. Conclusion AIFC could provide enough support, anti-slide function and high fusion rate. The pedicle screw systems could further increase immediate stability of lumbar vertebrae. It has satisfactory reduction rate and excellent clinical result to treat lumbar spondylolisthesis with AIFC and pedicle screw systems.