复合骨环行前路腰椎椎间融合术治疗腰椎滑脱症

Treatment of Spondylolisthesis by Anterior Lumbar Interbody Fusion With Composite Cortical Ring

目的 应用复合骨环行前路腰椎椎间融合术治疗腰椎滑脱症。方法 本组患者共１４例，男６ 例，女８ 例；年龄４０～５６ 岁，平均４６ 岁。Ⅱ度滑脱者１０ 个节段，Ⅰ度滑脱者５ 个节段。所选用的后路复位内固定中，ＲＦ钉１０ 例，短Ｈａｒｒｉｎｇｔｏｎ 棒４ 例。椎间植骨材料为同种异体冷冻干燥股骨环加自体松质骨（简称复合骨环）。根据手术前后的Ｘ 线片和ＪＯＡ 评分，判定前路腰椎椎间植骨的骨融合率和临床效果。结果 随访７～４１ 个月，平均２６ ．６ 个月。经Ｘ 线片检查，１４ 例患者的１５ 个椎间隙（ 其中１ 例为二个椎间植骨） 的融合率为８５ ．７％ ，ＪＯＡ 评分计算的术后改善率为７３．３％ 。结论 复合骨环行前路腰椎椎间植骨可以更好地恢复脊柱结构的完整性，保持术中撑开的椎间高度，融合率较高，可获得良好的治疗效果。

Objective\ Treatment of spondylolisthesis using freeze dried femoral ring allografts plus morselled cancellous autografts (called as composite cortical ring) by anterior lumbar interbody fusion (ALIF). Methods\ Fourteen patients were treated by this procedure, there were six males and eight females. The age of the patients range from 40 to 56(average 46). Ten segments were of grade Ⅱspondylolisthesis, five segments were of gradeⅠ. Ten patients were treated with RF as internal fixation, four patients with short Harrington rod as internal fixation. Results\ The fusion rate and clinical results of ALIF were analyzed by comparing the findings on the X-ray films taken preoperatively and 6 months postoperatively as well as by JOA score. The fusion rate of 15 segments of 14 patients(two segments of 1 patient was fused) is 85.7%, the average improvement rate of JOA score is 73.3%at an average follow up of 26.6 months. Conclusion\ ALIF with composite cortical ring could successfully restore the spinal structure, maintain the interspace height distracted intraoperatively, obtain high fusion rate and excellent clinical results.\;