GSS-Ⅱ型内固定加椎间植骨和后外侧植骨融合治疗腰椎滑脱症

Treatment of lumbar spondylolisthesis with GSS-Ⅱ spinal system combined with posterior lumbar interbody fusion and posterolateral fusion

目的：总结采用后路椎管减压，椎体及横突间植骨和GSS-Ⅱ脊柱内固定系统治疗腰椎滑脱症的临床疗效。方法：对我院2004年1月～2007年7月收治的34例腰椎滑脱患者进行系统回顾。其中男11例，女23例；Ⅰ度10例，Ⅱ度21例，Ⅲ度3例；采用GSS-Ⅱ系列滑脱系统对滑脱椎体进行复位、固定、后路椎管减压、椎体及横突间植骨融合治疗。结果：患者均获随访，时间12～36个月，平均11个月。10例Ⅰ度和20例Ⅱ度患者滑脱完全复位，1例Ⅱ度和3例Ⅲ度者滑脱复位达90％，未见螺钉松动或断裂，无植骨块脱出，植骨均达骨性愈合。根据JOA评定标准：优41例，良4例，可1例。结论：应用GSS-Ⅱ椎弓根固定系统结合椎体及横突间植骨具有操作简便、复位效果好、植骨融合率高及固定可靠的优点，临床疗效满意。

Objective：To evaluate the clinical results of spondylolisthesis with GSS-Ⅱ spinal system and posterior lumbar interbody fusion and posterolateral fusion. Methods： The data of consecutive 34 patients with lumbar spondylolisthesis admitted in our hospital between January 2004 and July 2007 were reviewed. The ratio of male to female were 11：23. 10 cases were in I degree and 21, in Ⅱ degrees. The total 34 cases underwent fixation with GSS-Ⅱ type transpedicle screws, interver- tebral fusion and posterolateral fusion. Results ： The follow-up of 34 patients, ranging from 6 to 12 months with an average of 11 months, revealed that 10 cases of grade I degree and 20 cases of grade Ⅱ degrees of spondylolisthesis achieved anatomic reduction of slided intervertebral bodies, 1 cases of grade Ⅱ degrees and 3 cases of Ⅲ degrees of spondy- lolisthesis achieved 90% reduction. No screws loosening or breakage or bone graft protrusion was found. Evaluation by the low back pain of JOA score, 29 cases ranked excellent, 4, good and 1, fair. Conclusion ： GSS-Ⅱ spinal system and posterior lumbar interbody fusion combined with posterolateral fusion has the advantages of easy manipulation, good reduction,high fusion rate and reliable internal fixation with satisfactory results.