腰椎滑脱症手术复位情况分析

Analysis of reduction of lumbar spondylolisthesis patients after surgical treatment

目的探讨腰椎滑脱症手术复位与疗效的关系，分析影响手术复位的因素。方法根据滑脱复位情况，选择46例手术治疗的腰椎滑脱症患者分为两组，解剖复位组24例，未解剖复位组22例，测量术前滑脱椎间隙高度、统计Ⅱ度滑脱例数。随访8～18个月，末次随访时评价手术疗效及融合率，并进行统计学分析。结果解剖复位组与未解剖复位组的手术优良率分别是91．6％和86．3％（P〉0．05）；术前椎间隙相对高度分别是（0．34±0．07）cm和（0．22±0．05）cm（P〈0．05）；11度滑脱比例分别是25．0％和63．6％（P〈0．05）；末次随访时两组融合率均为100％。结论Ⅱ度以下腰椎滑脱症手术后解剖复位与未解剖复位不影响手术疗效和融合率；滑脱程度加重和术前椎间隙变窄影响手术复位。

Objective To evaluate the relation of reduction and operation effect for lumbar spondylolisthesis patients, and analyse the influencing factor of surgical reduction. Methods According to reduction results, 46 selected cases were divided into two groups： anatomical reduction for 24 cases, non - anatomical reduction for 22 cases. Pre - operation percentage disc height was measured, and cases of grade two were counted. For 8 - 18 months follow - up, operation effect in the last follow - up and fusion rate were calculated. Results In anatomical reduction group and non - anatomical reduction group, the excellent and good rate was 91.6% and 86.3% （ P 〉0.05） , respectively; the pre - operation percentage disc height was （0.34 ± 0.07 ） cm and （0.22 ± 0.05 ） cm （ P 〈 0.05 ）, respectively ; the rate of grade two was 25.0% and 63.6% （ P 〈 0.05 ） , respectively. The fusion rate in two groups both were 100%. Conclusions For grade I and II lumbar spondylolisthesis, the operation effect and fusion rate has no significant difference in anatomical reduction and non- anatomical reduction patients; severe degree and lower pre -operation percentage disc height affect reduction.