腰椎多节段退变性滑脱的手术治疗

Surgical treatment for multi-level degenerative lumbar spondylolisthesis

目的:研讨腰椎多节段退变性滑脱手术减压和植骨融合方式与疗效的关系。方法:20例腰椎多节段退变性滑脱患者行后路椎弓根螺钉复位内固定后,采用椎管减压、神经根松解,行椎间植骨和后外侧植骨融合术,采用日本整形外科学会(JOA)下腰痛评分标准评价疗效。结果:获得连续随访者18例,随访时间9月～3年,平均24个月,优良率90%。结论:可靠的内固定、复位,神经根松解,椎间植骨融合治疗腰椎多节段退变性滑脱效果满意,充分的神经根松解是手术治疗的关键。

Objective：To investigate the curative effect of the posterior decompression and bone grafting fusion in patients with multiple-level degenerative lumbar spondylolisthesis.Methods：Twenty patients were undergone decompression of nerve root and vertebral canal,bone graft and fusion through intervertebral body and posterolateral fusion with a pedicle screws system.The curative effect assessment standard of Japanese JOA was used to assess the effect.Results：Eighteen cases were followed-up for 9～36 months（the average time of 24 months）.The good rate amounted to 90%.Conclusion：It is an effective way to treat multiple-level degenerative spondylolisthesis with strong fixation,full decompression of nerve root and bone graft and fusion through intervertebral body.The key is full decompression of nerve root.