椎弓根内固定结合后路椎间融合器治疗腰椎滑脱

Treatment of lumbar spondylolisthesis with pedicle screw fixation and interbody fusion cage

目的研究分析和总结腰椎滑脱后路复位内固定后远期脊柱再失稳的原因并寻求对策。方法采用国产和进口RF椎弓根内固定器械结合进口椎间融合支架共治疗12例。其中Ⅱ°11例,Ⅲ°1例。结果复位满意率平均96%,全部病例椎弓根钉及椎间融合支架置入准确,内固定牢固,脊柱长期稳定性良好。8例术前症状完全消失,4例仍有劳累或天气变化时轻度腰部及臀部疼痛。本组无1例马尾神经、神经根及大血管损伤。无椎间融合支架移位和下肢深静脉栓塞。结论椎弓根内固定结合后路椎间融合支架治疗腰椎滑脱效果良好。二者起到了相互协同相互促进的作用。如熟练掌握椎弓根内固定及椎间融合支架置入技术,远期相关并发症可以减少或避免,脊柱可获长期稳定。

Objective: To study the technique and outcome of lumbar vertebral instability by posterior route internal fixation with threaded fusion cage and pedicle screw fixation.Method:Twelve patients underwent operation using fusion cage and pedicle screw fixation system,11 cases were grade Ⅱ,1 case was grade Ⅲ.Result:The rate of good to excellent was 96%.The position of fusion cage and pedicle screw were accurate in all patients,stability of spine was fine for long symptoms disappeared in 8 cases,4 cases leave slight lumbago.Without complication occurrences in all patients so as coccygeal nerve、internal fixation displacement and great vessels injury.Conclusion:There are stable spinal fixation, high incidence fusion rate and excellent clinic with threaded fusion cage and pedicle screw fixation. Surgery complications can be avoided by improving surgical technique.