后路椎间植骨融合治疗退行性腰椎滑脱症

Degenerative spondylolisthesis treated with posterior lumbar interbody fusion

目的观察后路椎体间植骨辅以短节段复位固定治疗退行性腰椎滑脱症的临床效果。方法采用自体骨行椎体间植骨,加椎弓根螺钉系统短节段撑开复位固定治疗42例退行性腰椎滑脱症,随访12～60个月,定期摄X线片观察其融合率与临床效果。结果所有的患者均在术后12～18个月获得骨性融合,其中32例在9个月后融合。滑移复位情况：36例术后滑移程度小于5%,6例小于15%。临床效果评价：优26例,良16例。结论后路椎间植骨是治疗退行性腰椎滑脱症的较好方法,具有神经根、硬膜囊减压彻底及融合可靠的特点。

Objective To observe the results of the degenerative lumbar spondylolisthesis treated with PLIF using transpedicular screw/rod fixation. Methods 42 patients with degenerative lumbar spondylolisthesis underwent a PLIF using autogenous bone fusion oriented counter anterolaterally on the symptomatic side with same level supplemental transpedicular screw rod fixation. Patients had at least one year of low back pain and/or sciatica, patients were followed up from 12 to 60 months. and a severely restricted functional ability. The The stability and fusion of the disorder segments were observed on the X-ray film. Results All these 42 patients achieved successful radiographic fusion at 12 to 18 months. Clinical results： 26/42 patients were excellent, 16/42 patients were good, and no poor clinical results. No implant fractures or deformities occurred in all patients. Conclusion The aim of surgical treatment of degenerative lumbar spondylolisthesis is solid interbody fusion on the basis of adequate decompression of the neurological structures, and appropriate lumbar lordortic alignment and limited reduction through distraction of the interbody space using autogenous bone with supplemental transpedicular screw rod instrumentation.