椎弓根内固定加后外侧植骨融合治疗退变性腰椎不稳

Pedicle instrumentation and posteriolateral bone grafting for treatment of degenerative instability of lumbar spine

目的探讨椎弓根内固定加后外侧植骨融合治疗退变性腰椎不稳的临床疗效。方法对86例腰椎不稳患者采用椎弓根螺钉内固定加后外侧植骨融合治疗，JOA下腰痛评分标准评价临床效果。结果86例均获随访，时间1～4年。所有患者术后X线片显示植骨骨性融合，未发现脊柱假关节形成及内固定松脱、断裂，术后无再发生腰椎不稳定。JOA下腰痛评分：术前平均（4．6±1．3）分，术后（13．4±1．6）分。平均改善率88％，优良率96％。结论椎弓根内固定加后外侧植骨临床疗效好，骨性融合率高，是治疗退变性腰椎不稳的较好方法。

Objective To observe the clinic curative effect of pedicle instrumentation and posteriolateral bone grafting for treatment of degenerative instability of lumbar spine. Methods 86 cases with degenerative instability of lumbar spine underwent pedicle instrumentation and posteriolateral bone grafting ,and the clinic curative effect was evaluated by JOA lower back pain score standard. Results 86 cases had been followed up for 1 to 4 years. All the cases had displayed bony fusion by X-ray, and spine pseudoarticulation formation and the internal fixation loosening or breakage was not found. No instability of lumbar spine occurred. Preoperative JOA lower back pain score averaged （ 4.6 ± 1.3 ）, and postoperative it averaged （ 13. 4 ± 1.6 ）. Postoperative improvement rate averaged 88% , and tile excellent and good rate averaged 96%. Conclusions The clinic curative effect of pedicle instrumentation and posteriolateral bone grafting can provide excellent effect, high bony fusion rate. It is a good method to treat degenerative instability of lumbar spine.