BAK椎间融合器治疗轻度腰椎峡部型滑脱症

Mild Lumbar Isthmic Spondylolisthesis Treated with BAK Interbody Fusion Cage

自1997年4月～1998年4月间,以多孔螺纹状椎间融合器(BAK)行后路腰椎椎体融合术(PLIF)治疗8例轻度L_5/S_1峡部型滑脱症病人。患者主要症状为反复发作的下腰痛,伴有一侧(5例)或双侧(3例)的下肢疼痛。术前侧位X线片显示腰5椎体轻度向前滑脱(15％～30％滑移程度),且该椎间隙高度较邻近之正常间隙降低30％以上;斜位片示峡部裂隙6例(其中1例为单侧)、峡部细长2例。双侧症状者行后前向双枚BAK椎间融合器PLIF。术后平均随访12月,皆达到临床融合。所有患者均无融合器的移位,患者主观满意率100％。作者认为,BAK椎间融合器植入行后路腰椎椎体间融合术,能充分完成后路减压、保证可靠的融合,且无需应用附加内固定,不失为一种比较理想的治疗轻度腰椎峡部型滑脱手术方法。

From May of 1997 to April of 1998, we treated eight patients with lumber isthmic spondylolisthesis with pos-terior lumber interbody fusion (PLIF) by insertion of BAK threaded cages.The safety, fusion success rate, and clinical outcome of BAK cages insertion in treatment of isthmic spondylolisthesis were evaluated in this study. All patients had L5/ S1 isthmic spondylolisthesis (less than 30% slipping) with severe low back pain and leg pain in one side (5 cases) and both sides (3 cases) .All patients accepted PLIF with two BAK cages insertion under total laminectomy and both sides facetectomies.All patients were followed up from 6 to 15 months (average 12 months) .All achieved clinical fusion.All patients estimated a 90% or better improvement over the preoperative symptoms.There were one patients had an early, substantial foot- drop that recovered within 3 months.So we concluded that mild lumbar isthmic spondylolisthesis can be treated by PLIF with insertion of a two BAK cages without additional instrumentation.