影响DF钢板治疗腰椎滑脱症手术疗效的原因分析

The Analysis of the Effect Factor of the Treatment of Internal Fixation of Lumbar Spondylolisthesis with DF Plate.

目的 探讨椎弓根固定系统内固定手术治疗腰椎滑脱症疗效未达到预期效果的原因。方法用椎弓根固定系统对95例腰椎滑脱症进行手术复位内固定，术后随访1年以上，对Ⅰ级（差），Ⅱ级（可）的临床资料进行分析。结果按sfeffee分级：Ⅰ级（差）1例，Ⅱ级（可）4例、Ⅲ级（良）36例、Ⅳ级（优）54例。对Ⅰ级Ⅱ级大概原因分析，Ⅰ级1例椎弓根螺丝松动，Ⅱ级2例是椎板减压不充分，另2例是滑脱椎体复位程度过大。结论严格把握手术适应证，对椎管狭窄减压应彻底，充分的植骨融合，重度滑脱椎体复位程度不可过大，是手术成功的关键。

Objective To investigate the cause of failure of internal fixation of lumbar spondylolisthesis with DF plate. Methods All the 95 eases suffered from lumbar spondylolisthesis treated with DF plate internal fixation were followed up for one year at least, Analysis was taken to the clinical date of grate Ⅰ and grade Ⅱ, Results According to the criteria of stefee, The results showed grate Ⅰ（bad） in Ⅰ, grate Ⅱ （not fine） in 4, grate Ⅲ （good） in 36, grate Ⅳ （excellent） in 54. The failures includes screw breakage in 1, not fully decompressed in 2, over reduced spondylolisthesis verthebar in 2. Conclusion Strictly holding the sign of operation, and making bone transplantation and fusion, thoroughly decompressing the vertebra, spondylolisthesis vcrtebar should not be over reduced and thoracolumbar protective brace should be adopted postoperativly.