RF-Ⅱ系统内固定结合后路椎间融合器治疗腰椎滑脱症38例分析

Treatment of lumbar spondylolisthesis with RF-Ⅱ system and posterior interbody fusion cage

目的探讨后路椎间融合加RF系统经椎弓根固定治疗腰椎滑脱症的手术疗效。方法38例腰椎滑脱症患者经手术减压、神经根松解,行椎间植骨融合加RF-Ⅱ系统内固定手术治疗;术毕放置负压引流24～72 h;术后下肢功能锻炼预防深静脉栓塞,卧床6～8周,并在卧床条件下进行腰背肌及双下肢肌肉和大关节功能练习。结果术后随访2～4年,32例术后症状全部消失,其中4例仍有劳累时腰部及臀部轻度疼痛;1例骶尾部褥疮致切口感染,经后期处理愈合;1例椎间融合器移位,嘱患者卧床休息,减少腰部活动后融合。结论椎弓根内固定结合后路椎间融合术治疗腰椎滑脱起到相互协同相互促进的作用,能够获得满意的临床疗效,并减少了并发症,脊柱可获得长期稳定。

Objective To study the effect of treatment lumbar spondylolisthesis with posterior interbody fusion and RF system pedicle fixation.Methods Totally 38 cases with lumbar spondylolisthesis treated by operation for decompressing lumbar canal,releasing nerve root,the fusion（posterior lumber interbaby fusion） plus RF-Ⅱ fixation system.negative pressure drainage was put for 24 to 72 hours after operation.Lower limb functional exercise was get for preventing venous embolism.Lying in bed 6 to 8 weeks,and exercise for muscles of lapara,back and both lower extremities,big joint.Results All 38 cases were follow-up for 2 to 4 years.Symptoms of 32 patients disappeared,4 cases felt a light pain for exertion,1 case suffered infection for sacroiliac decubiti,and 1 patient underwent fusion cage shifting.All cases healed at last.Conclusion posterior interbody fusion and RF system pedicle fixation enhanced each other for treatment of lumbar spondylolisthesis.It is a good and effective method for less omplication and longer stabilization.