改良后路椎间融合术治疗腰椎不稳

Treatment Of Lumbar Instability with Improved Posterior Lumbar Interbody Fusion

目的:探讨改良后路椎间融合术(PLIF)治疗腰椎不稳的指证、方法和疗效。方法:采用改良后路椎间融合术手术治疗各种原因引起的腰椎不稳共41例,随访时间12个月～36个月。结果:36例下腰痛及下肢痛症状完全缓解,3例明显好转,2例术后神经根出现疼痛加重。影像学结果显示28例滑脱病例中24例完全复位,4例仍存在Ⅰ度滑脱。所有病例椎间高度恢复正常,无植入物(髂骨块、椎间融合器)移位或下沉情况,1例出现椎弓根螺钉断裂。41例病人中有40例获得骨性融合,1例有假关节形成。结论:PLIF是治疗腰椎不稳所致慢性腰腿痛的确切有效的方法,不仅可以恢复椎间隙高度,而且有较高的骨性融合率(97.5%)。

Objective：To study the indication, method and clinical outcomes of proved posterior lumbar interbody fusion（PLIF）on lumbar instability. Methods：41 cases with lumbar instability were treated by PLIF. The follow-up periods ranged from 12 months to 36 months. Results：The symptom of 36 patients was completely resolved, 3 patients improved obviously, but 2 patients aggravated. It was showed that spondylolisthesis of 24 patients was completely reposited on the radiography, and there are 4 patients with spondy lolisthesis of grade I. 40 cases had solid fusions and one had pseudarthrosis radiographically. Conclusion：PLIF might be an effective method to treat lumbar segmental instability, which could relieve low back pain of patients with lumbar instability and improve lumbar fusion rate effectively.