后路椎间融合术治疗腰椎滑脱疗效观察

Curative effects of posterior lumbar interbody fusion in the treatment of lumbar spondylolisthesis

目的:探讨后路椎间融合术(PLIF)治疗腰椎滑脱的临床疗效。方法:对本院2008年5月～2010年3月15例腰椎滑脱患者采用椎间融合术进行治疗,对其疗效及手术方法进行回顾性分析。结果:本组15例患者均获得随访,随访12～48个月,平均22个月,术后滑脱完全复位率为93.33%(14/15),14例示椎间植骨融合良好,无复位丢失及断钉,融合率为93.33%(14/15);术后症状完全消失13例,明显减轻2例,2例Ⅲ度滑脱复位后仍然有Ⅰ度滑脱,经植入椎间钛合金支架(BAK)未出现松动,椎间高度无丢失,其余患者完全复位。结论:椎间融合术经一侧即能得到双侧前柱的融合,植骨融合快,融合率高,椎体间融合良好,手术时间短,创伤小,并发症少,并能提供稳定的生物力学环境,不失为治疗腰椎滑脱症的一种较好方法。

Objective： To investigate the therapeutic efficacy of posterior lumbar interbody fusion in the treatment of lumbar spondylolisthesis. Methods： 15 cases of lumber spondylolisthesis were treated with interbody fusion in our hospital from May 2008 to March 2010. The therapeutic efficacy and surgical techniques of the 15 cases were analyzed retrospectively. Results： The 15 patients were followed up for 12 to 48 months, with an average length of 22 months. Complete slippage restoration was 93.33% （14/15） after surgery. 14 patients showed good interbody fusion, with no restoration loss and screw breakage, and a fusion rate of 93.33% （14/15）; symptoms disappeared completely in 13 cases, significantly reduced in 2 cases. And 2 cases of Ⅲ points spondylolisthesis still showed Ⅰ points spondylolisthesis after restoration. The implanted BAK did not get loose and there was no loss of intervertebral height. The rest of the cases all achieved complete restoration. Conclusion： Posterior lumbar interbody fusion in one side can achieve bilateral anterior column fusion, and fusion was fast, effective and solid, with a shorter operative time, less trauma and fewer complications, and can also provide a stable biomechanical environment, thus PLIF is a relatively effective treatment of lumbar spondylolisthesis.