经后路椎弓根复位固定 椎间融合治疗腰椎滑脱症

Saggittal lumbar alignment reconstruction for surgery treatment of lumbar spondylolisthesis

目的探讨手术治疗腰椎滑脱症的临床疗效。方法对35例腰椎滑脱的患者实施手术治疗,用Megerding分度,Ⅰ:滑脱8例,Ⅱ;滑脱18例,Ⅲ:滑脱9例。其中真性滑脱20例,假性滑脱15例。术中根据病变的分类及影像学特点采取不同的减压和复位内固定、椎间植入骨块或cage。结果术后平均随访28个月。比较手术前后临床症状和x线片及CT片,30例临床症状完全消失,优良率85.7%。X线片及CT片显示,27例完全复位,8例由Ⅲ。恢复到Ⅰ并无一例发生感染及神经根损伤。临床Oswestry功能障碍评分由术前(33.8±4.5)分将至术后1年为(17.8±4.2)分,术后2年为(10.6±4.7)分,表明临床疗效显著。结论手术治疗腰椎滑脱是恢复腰椎正常序列的有效可靠的方法。

Objective To investigate the surgical treatment of the clinical resutes to lumber spondylolisthesis. Methods From June 2000 to May 2008,35 cases of I abover lumber spondylolisthesis were treated with surgery . According to Meyerding elassification of lumber spondylolisthesis, 8 cases were classified as degree 1 , 18 cases as degree 2, 9 cases as degree 3. Polycythemia lumber spondylolisthesis 20 cases ande Pseudocyst 15 cases. During the operation . We took different methods of decompression and reduction . According to classification and maging characteristics, and the cage or iliac bone block were implanted into the intevertebra. Results Thepatients were followed up from 16 to 38 mpnths. With an average of 26 months. The results showed that the pre-operative clinical symptoms disappeared completely in 30 of 35 cases. Pain relief was seen in 85.7%. 8 eases with degree 1 and 18 cases with degree 2 and 1 of 9 cases with degree 3 obtained the complete reduction of the slide intervertebral body. 8 cases were reduced from degree 3 to degree 1. There were no infection and nerve injury. The objective clinical outcomes of the Oswestry disability questionnaire were in average（33.8 ±4. 5） before operation and（17.8±4. 2）at 1 year and （10. 6 ±4. 7）at 2 years postoperatively. Concluslon Surgery treatment lumber spondylolisthesis is effective and reliable methed of.