脊柱融合术治疗退变性腰椎滑脱症的疗效分析

Analysis of clinical effect of spinal fusion in treating degenerative lumbar spondylolisthesis

目的:分析两种脊柱融合术治疗Meyerding Ⅰ-Ⅱ度退变性腰椎滑脱症的疗效。方法:对2002年2月至2008年3月收治的Meyerding Ⅰ-Ⅱ度退变性腰椎滑脱症36例患者进行回顾性分析,其中男26例,女10例;年龄40～69岁,平均59.05岁。36例中16例采用椎板减压原位内固定后外侧植骨融合(A组),20例采用椎板减压复位内固定椎间融合(B组)。对两组手术时间、手术出血量进行比较并按Nakai标准对疗效进行分析。结果:A、B组手术时间分别为(101.75±10.22)、(110.85±9.63)min,手术出血量分别为(510.62±71.78)、(574.50±82.30)ml,均有统计学差异(P<0.05)。所有患者均随访2年以上,按NaKai评定标准:A组优8例,良6例,中2例;B组优12例,良5例,中3例,两组疗效无统计学差异(P>0.05)。结论:采用椎板减压原位内固定后外侧植骨融合和椎板减压复位内固定椎间融合治疗Meyerding Ⅰ-Ⅱ度退变性腰椎滑脱均能获得满意疗效,但椎板减压原位内固定后外侧植骨融合的手术时间更短,出血量更少。

Objective：To analyze the clinical effect of spinal fusion in treating degenerative lumbar spondylolisthesis of Meydrding Ⅰ-Ⅱdegree. Methods：From February 2002 to March 2008,36 patients with degenerative lumbar spondylolisthesis of Meydrding Ⅰ- Ⅱ degree were treated with surgery,of which data were analyzed retrospectively. There were 26 males and 10 females,ranging in age from 40 to 69 years with an average of 59.05 years. Among them,16 cases were operated by laminectomy with situ posterolateral fusion and internal fixation （group A） and 20 cases by laminectomy with interbody fusion and internal fixation （group B ）. The operative time,volume of blood loss were compared between two groups and the clinical effects were analyzed according to standards of Nakai. Results：The operative time in group A and B group was （101.75±10.22）,（110.85±9.63） min and volume of blood loss was（510.62±71.78）,（574.50±82.30） ml,respectively. There was statistical difference between two groups （P0.05）. All patients were followed up more than 2 years. In group A,8 case obtained excellent results,6 good,2 fair; in group B,12 obtained excellent result,5 good,3 fair. There was no significant difference between two groups（P0.05）. Conclusion：Laminectomy and spinal fixation in situ posterolateral fusion and interbody fusion both can obtain satisfactory result in treating degenerative lumbar spondylolisthesis of Meydrding Ⅰ-Ⅱ degree,but by posterolateral fusion and internal fixation has less volume of blood loss and short operative time.