腰椎滑脱后路术后并发症分析

The Long-term Complications Associated with Internal Fixation for Lumbar Spondylolisthesis

目的:统计分析椎管减压,后路器械复位内固定术治疗腰椎滑脱患者术后2年～3年年中的并发症,探讨其发生的原因及防治措施。方法:统计分析2003年～2005年间收治的35例椎管减压后路器械复位内固定并植骨融合治疗腰椎滑脱病人2年后并发症,分析其原因,探讨其预防措施。结果:35例患者中,术后腰痛及下肢痛3例(8.57%),假关节形成2例(5.71%),下肢痛伴麻木1例(2.85%)。结论:腰椎滑脱后路手术复位内固定并植骨融合具有较好的临床效果,下腰痛、假关节形成和下肢神经痛是其主要并发症,应高度重视手术的规范性操作。

Objective： To review and evaluate the clinical outcome of lumbar spondylolisthesis treated by decompression , instrumentation and posteriolateral fusion in order to analyze the causes and the managements of the long-term postoperative corn -plications. Method From 2003 to 2005 year , 35 cases with grade Ⅰ to Ⅱ spondylolisthesis treated by posterior lumbar canaldecompression, reduction with pedicle screw systems and fusion with posteriolateral bone grafting were reviewed. There were 15 males 20 females with an average age of 42. 3 years old. According to Meyerding classification , there were 26 cases of grade Ⅰ and 9 cases of grade Ⅱ. Result ： The long-term complications included persistent low back pain in 3 （8. 57 %） , pseu-doarthrosis formation in 2 （5. 71%） and lower limb pain with numbness in 1 （2. 85%） . Conclusion ： Good clinical results hasbeen obtained in using posterior reduction and fixation pedicle screw system dealing with grade Ⅰ and grade Ⅱ lumbar spondylolisthesis , pseudoarthrosis fromation and persistent neurological deficits are the common complication and moreattention should be paid to operative technique.