腰椎后路360°环形融合术治疗腰椎滑脱50例疗效观察

Clinical effect of the 360°annular arthrodesis via the posterior lumbar in the treatment of lumbar spondylolisthesis

目的探讨腰椎后路360°环形融合术治疗腰椎滑脱的临床疗效。方法将2005-2010年在我院住院的腰椎滑脱患者100例平均随机分为PLF组和360°环形融合组各50例,PLF组行传统后外侧植骨融合术,360°环形融合组行后路椎体间融合术加后外侧植骨融合术,比较两组患者术前术后影像学指标、JOA腰椎评分、Oswestry评分的变化情况,并行组间对比。结果 PLF组和环形融合组手术后Cobb's角均明显下降至小于10°,组间角度差异有统计学意义(P<0.05)。PLF组、环形融合组治疗后运动能力、感觉能力、膀胱功能及JOA总分、Oswestry评分均较治疗前提高,以上指标前后差值组间比较,环形融合组恢复优于PLF组(P<0.05)。结论腰椎后路360°环形融合术治疗腰椎滑脱能更好改善患者影像学指标,提高JOA评分和Oswestry评分,值得进一步探讨和推广。

Objective To discuss the clinical effect of the 360°annular arthrodesis via the posterior lumbar to cure lumbar spondylolisthesis. Methods 100 patients suffered the lumbar spondylolisthesis were selected from 2005 to 2010, and evenly were divided into the PLF group and the 360°annular arthrodesis group at random. Conduct the traditional posterolateral fusion for PLF group and the posterior lumbar interbody fusion and posterolateral fusion for the 360°annular arthrodesis group, and compare the changes of the image index, JOA lumbar mark and the Oswestry marks before and after the treatment and compare the conditions between the two groups. Results The Cobb angle in two groups have reduced to be lower than 100 after the operation, and the difference is significant between the two groups （P〈0.05）. Compared with PLF group and 360° annular arthrodesis group, the locomotivity, perceptibility, blad- der fimction, JOA marks and Oswestry marks have been improved after the operation. The above indexes in annular arthrodesis group is better than those in the PLF group. Conclusion The 360~annular arthrodesis via the posterior lumbar earl improve the image index and promote the JOA marks and Oswestry marks, and hence has good efficacy in the treatment of lumbar spondylolisthesis.