后路自体髂骨椎体间植骨融合治疗腰椎滑脱症的临床研究

Clinical study on treatment of spondylolisthesis by posterior iliac bone grafting and interbody fusion

目的：探讨自体髂骨椎间植骨融合内固定术治疗腰椎滑脱症的手术方法及临床疗效。方法：26例腰椎峡部裂伴椎体滑脱或腰椎退行性变滑脱所致腰椎失稳症病人行后路减压内固定自体髂骨椎体间植骨融合术。结果：随访26例（6～38月），12～18个月椎体间骨性融合，无神经根及马尾神经损伤，无植骨块脱落。stauffer-coventry下腰椎术后疗效评定标准，优17例，良3例，可1例，经X线片或CT复查椎间达骨性融合，无内固定松动、断裂、无复位度数丢失，无椎间塌陷。结论：经后路减压内固定自体髂骨植骨融合是治疗腰椎滑脱症的理想方法。具有植骨量大、融合率高、费用低、椎间高度丢失少、操作简单，疗效肯定。

Objective.To study operative methods and outconle of spondylolisthesis treated by iliac bone grafting and interbody fusion. Methods ：Twenty six patients with lumbar isthmic fracture and spondylolisthesis or degenerative instability were given the posterior decompression, iliac bone grafting and interbody fusion. Results：Twenty six patients were followed up （6 - 38months ）. Bony fusion happened within 12 - 18months, without injury of nerve root, coecygeal nerve and shedding of bone graft. According to Stauffer Coventry criteria, excellent （ 17 ） , good （ 3 ） and acceptable （ 1 ） were demonstrated. Rechecked with X - ray and CT scan, bony fusion was found without loosening or breakage of internal instrument, loss of angle or collapse of vertebrae. Conclusion ： It is an ideal method for posterior decompression, internal fixation and interbody grafting of auto - iliac bone to treat spondylolisthesis, with advantages such as sufficient bone graft, high fusion rate, low expense, less loss of intervertebral height, easy manipulation and reliable outcome, etc.