TLIF结合椎弓根钉内固定治疗峡部崩裂型腰椎滑脱症

Transforaminal Lumbar Interbody Fusion combined with Screw Fixation for the Treatment of Isthmic Lumbar Spondylolisthesis

目的:探讨经腰椎间孔入路腰椎体间植骨融合术治疗腰椎滑脱症的有效性及安全性。方法:手术治疗腰椎滑脱症12例。采用腰椎后正中切口,行相应节段椎弓根复位内固定,经单侧腰椎间孔入路腰椎体间植骨融合(TLIF),并使用2枚钛网或单独进行自体髂骨植骨。术后随访观察椎体间植骨融合情况及临床效果,按JOA评分进行疗效评价。结果:全部患者切口一期愈合,无神经根损伤、椎间隙感染和脑积液漏等并发症。12例均获随访,随访时间7～17月,平均12个月。无1例发生内固定物松动移位或断裂,椎间隙高度无丢失。骨融合率为100%,疗效优良率91.6%。结论:TLIF结合椎弓根钉复位内固定治疗腰椎滑脱症是一种有效及安全的手术方式。

Objective：To explore the advantages, validity and safety of the transforaminal lumbar interbody fusion （TLIF） in the treatment of lumbar spondylolisthesis. Methods： The midian incision of lumbar and internal fixation of the corresponding lateral mass of vertebrae were performed on 12 patients with lumbar spondylolisthesis, then the TLIF combined with two titanium cages or only self-ilium grafting were carried out. The postoperative interpyramidal fusion and clinical outcomes were observed and evaluated by JOA Scores. Results： 12 patients were followed up from 7 to 17 months （averege of 12 months）, their incisions got primary healing, without complications such as damage of nerve root, infection of intervertebral space and brain liquorrhea and et al. The rate of bone confluence was 100% , the fine rate of curative effect was 91.6% , no fixity cinching and shifting or breaking, the height lost of intervertebral space were observed. Conclusion：TLIF is a feasible and safe method in the treatment of lumbar spondyloisthesis,is worth further spreading.