椎弓根螺钉内固定加植骨融合治疗腰椎滑脱

Treatment of spondylolisthesis by pedicle screw fixation with posterior fusion

目的:探讨后路椎弓根内固定加植骨融合治疗腰椎滑脱症的临床效果和治疗原则。方法:采用腰椎后路椎管减压、椎弓根复位、内固定同时植骨融合治疗腰椎滑脱患者57例,其中Ⅰ型21例,Ⅱa3例,Ⅱb2例,Ⅱd31例,Ⅰ度滑脱27例,Ⅱ度滑脱28例,Ⅲ度滑脱2例。结果:术后随访7～37个月,52例骨性融合,骨性融合率为91.2%,临床疗效优良率为86.4%。结论:治疗腰椎滑脱应遵循减压、复位、固定、融合的原则,后路椎弓根内固定加植骨融合是治疗腰椎滑脱的成熟术式。

Objective： To investigate the effect and principle on treating spondylolisthesis through pedicle screw internal fixation and posterior fusion. Methods： Fifty-seven patients suffering from spondylolisthesis during Jan. 1998 to Oct. 2004 were treated by pedicle screw internal fixation with posterior fusion. Among them, 21 cases belonged to type Ⅰ, 3 cases type Ⅱa, 2 cases type Ⅱb, and 31 cases type Ⅱd. The slippage grade of 27 cases in grade Ⅰ, 28 cases in grade Ⅱ and 2 cases in grade Ⅲ. Results： Above patients were followed up 7～37 months. The fusion rate was about 91.2%, and the satisfactory rate 86.4%. Conclusions： Treatment of spondy lolisthesis should acts on principle as follows： decompression, reduction, internal fixation and bone graft fusion. The operation of pedicle screw fixation with posterior fusion is a safe and effective method in the treatment of spondylolisthesis.