Quadrant系统下椎间融合结合椎弓根内固定治疗腰椎滑脱症的临床探讨

Interbody fusion and pedicle screw fixation with a quadrant retractor system in the treatment of lumbar spondylolisthesis

目的探讨Quadrant系统下椎间融合结合椎弓根内固定治疗腰椎滑脱症的手术方法和临床疗效。方法腰椎滑脱症患者40例，根据临床症状、体征，CT扫描和／或MRI检查确诊。均在Quadran系统辅助下手术。结果40例手术顺利，无中转开放手术。手术时间120～170min，平均（157．3±18．8）min。切口均呈I／甲愈合。40例随访6～18个月，平均12．4个月，疗效评定按Nakai疗效评定标准：优21例，良17例，可2例，优良率95％（38／40）。结论Quadrant技术操作可行，是临床上可供选择的一种微创新术式。

Objective To examine the interbody fusion and pedicle screw fixation with a quadrant retractor system in the treatment of lumbar spondylolisthesis. Methods Forty patients with lumbar spondylolisthesis were enrolled in the study. The diagnosis was confirmed based on clinical symptoms ,signs, the results of CT scanning and/or MRI examination. Operations were conducted by using a quadrant retractor system. Results The operation was completed smoothly in all the 40 patients, which was not converted to open surgery. The operation time lasted 157.3 ± 18.8 min （ range ： 120 - 170 rain）. The wound was healed, which was classified as grade A. A follow - up lasting 6 - 18 months （ mean ： 12.4 months） was carried out. According to the Nakai classification,excellent efficacy was achieved in 21 patients,good in 17 patients,fair in 2, and poor in 0. The rate of excellent or good efficacy reached 95% （38/40）. Conclusion The quadrant retractor system is feasible and effective and provides an alternative to conventional surgical procedures.