三种术式治疗腰椎不稳症的临床疗效观察

Comparison of three different kinds of treatment for lumber instability

目的探讨3种术式治疗腰椎不稳症的疗效。方法对86例腰椎不稳症分3组，用3种手术方式治疗，对治疗结果进行回顾性统计分析。结果86例术后随访8～48个月，平均26个月。根据影像学检查，3组植骨融合率分别为78％、92．5％、95．5％。术后优良率分别为：1年82．5％，84.2％，85．5％；2年79．5％，84％，85．2％；3年75．8％，83.6％，85％。结论单纯后路植骨远期疗效不如联合椎弓根螺钉内固定加椎间融合；应根据腰椎退变及硬膜囊神经根受压的程度选择合适的融合术式。

Objective To compare different kinds of treatment for lumber instability. Methods Eighty-six patients with lumber instability were divided into three groups and treated with three different kinds of treatment. The therapeutic results were retrospectively analyzed. Results The follow-up period ranged from 8 to 48 months （ mean 26 months）. The radiographic fusion rate of the three groups was 78% ,92.5% ,95.5% respectively. The excellent and good result rate was 82.5% ,84.2% ,85.5% respectively in 1 year＇s follow-up ,79.5% ,84% ,85.2% in 2 years fol- low-up and 75.8% ,83.6% ,85% in 3 years follow-up. Conclusion The therapeutic effect of the combination of the posterior instrumentation,decompression of interbody fusion has a better effect than the posterior autografting. The fusion operation method should be carefully selected by the degree of lumber degeneration and nerve compression.