后路360°植骨融合椎弓根钉棒系统内固定置入治疗腰椎椎体滑脱症48例

Posterior circumferential(360 degrees) spinal fusion combined with pedicle screw fixation for 48 cases of lumbar spondylolysis

回顾性分析2006-02/2007-10应用后路椎弓根钉棒系统复位内固定、椎间Cage植骨及后外侧植骨360°融合治疗腰椎椎体滑脱症患者48例,其中单节段融合30例,二节段融合10例,三节段融合8例。置入前、置入后3d及最终随访时常规摄腰椎正、侧、双斜位片及过伸过屈侧位X射线平片;并分别测量滑移率、滑移复位率和植骨融合率;根据下腰痛JOA评分标准计算其恢复率。全部患者均获随访,结果显示恢复率为71.2%,滑移复位率为91%,植骨融合率为100%。X射线平片示滑移椎均全部复位,所有患者均未出现切口感染及局部炎症反应、排异反应等宿主反应,腰椎融合后,腰部伸屈功能部分受限。提示后路椎间360°植骨融合、椎弓根钉棒系统内固定可有效提高滑脱椎体复位及融合,改善患者临床症状。

A total of 48 cases of lumbar spondylolysis treated with posterior circumferential （360°） spinal fusion combined with the pedicle screw fixation from February 2006 to October 2007 were retrospectively analyzed. Single-level fusion was performed in 30 patients, two-level in 10 and three-level in 8. All of 48 cases were photographed at anterior-posterior, lateral and left-right oblique position and X-ray plain films of lumbar vertebrae before and three days after operation. The rate of lumbar spondylolysis, rate of reduction and solid fusion were measured. The recovery rate was evaluated based on JOA scores. All 48 cases were followed up. The rate of lumbar pain restoration was 71.2%, the rate of reduction was 91%, and the rate of solid fusion was 100%. X-ray plain films of lumbar vertebrae showed that the spondylolysis was reduced in all cases. No postoperative infection, inflammatory reactions or rejections occurred. The function of lumbar vertebrae was limited partly after solid fusion. The results show that posterior circumferential （360°） spinal fusion combined with the pedicle screw fixation can promote the rate of reduction and fusion of lumbar spondylolysis and improve the clinic symptoms of low lumbar pain efficiently.