椎弓根内固定联合椎间融合器植骨治疗腰椎滑脱症

Combined pedicle screw internal fixation with threaded interbody fusion cage for lumbar vertebral spondylolisthesis

目的探讨联合应用椎弓根内固定和椎间融合器植骨融合治疗腰椎滑脱症的方法和临床疗效。方法用后路减压、复位椎弓根内固定联合应用单枚斜向椎间融合器融合或单侧经椎间孔腰椎体间融合器融合治疗有症状的腰椎滑脱症。本组随访21例,时间6～24个月,平均14个月。结果滑脱椎体复位理想,8例Ⅰ度滑脱完全复位,13例Ⅱ度中有7例完全复位,6例仍有Ⅰ度滑脱。融合节段全部获得骨性融合。疗效评价:优14例,良5例,可2例;优良率94%。结论联合应用椎弓根内固定和椎间融合器植骨融合在治疗腰椎滑脱症起到协同作用,为神经减压后的脊柱提供理想的复位和固定的力量,利于植骨融合,临床疗效满意,是治疗腰椎滑脱症的一种理想方法。

Objective To study clinical results and methods of the posterior reduction and fixation with pedicle screw internal fixation combined with threaded interbody fusion cage for lumbar vertebral spondylolisthesis. Methods Twenty-one patients with lumbar vertebral spondylolisthesis, who had severe symptoms, were involved posterior decompression, reduction and fixation,among them,16 received combined with single posterolateral threaded fusion, 5 with transforminal lumbar threaded interbody fusion; the 21 cases were followed up from six months to twenty-four months(averaged 14 months). Results Satisfactory reduction were in 8 cases with Ⅰ° spondylolisthesis; among 13 cases with Ⅱ°spondylolisthesis, 7 were anatomic reductin, 6 were still Ⅰ° spondyloptosis. The bony fusion was achieved in all the cases. According to clinical evaluation, excellent results were seen in 14 cases, good results in 5 cases, fair results in 2 cases; the excellent and good rate was 94%. Conclusion Applying the posterior pedicle screw internal fixation combined with interbody threaded fusion cage may achive synergism in the treatment of lumbar vertebral spondylolisthesis. Above procedure is served as solid interal fixation and offeres a satisfactory reduction, and can improve the fusion rate of the spine, thus is ideal procedure and worthy of being recommended method for treatment of lumbar vertebral spondylolisthesis.