Semi-rigid动态系统治疗腰椎滑脱症的疗效分析

Analysis of efficacy of semi-rigid lumbar dynamic fixation for spondylolisthesis

目的观察腰椎后路semi-rigid动态内固定系统治疗腰椎滑脱症的疗效。方法回顾性分析32例腰椎退行性变患者的临床资料。按Newman分型:峡部滑脱18例,退行性滑脱14例,所有患者均行手术减压、腰椎后路semi-rigid动态内固定系统固定。分析术后Oswestry功能障碍指数评分(ODI)和日本骨科学会评分(JOA)改善情况,随访临床疗效及影像学观察结果。结果术后1年,ODI分值较术前下降[(12.15±5.27)分vs.(61.82±10.79)分](P<0.05),JOA分值较术前提高[(27.89±1.99)分vs.(9.28±1.86)分](P<0.05)。术后1年动态固定邻近节段退变椎间盘有逆退变过程演变的趋势。结论腰椎后路semi-rigid动态内固定系统是治疗腰椎滑脱症的有效方法,可预防和减少融合相邻节段的椎间盘退变。

Objective To evaluate the clinical efficacy of treating spondylolisthesis by semi-rigid lumbar dynamic fixation.Methods Surgical decompression and lumbar posterior semi-rigid dynamic internal fixation were performed in 32 patients with lumbar degeneration.The imaging features were followed up and ODI scores and JOA questionnaires were assessed before and after operation.Results All patients were followed up for 1 year.Compared to before,the ODI scores were decreased [（61.82±10.79） points vs.（12.15±5.27） points] and the JOA scores were increased after operation[（9.28±1.86） points vs.（27.89±1.99） points]（P〈0.05）.There was a tendency of reversing the degeneration of the adjacent lumbar intervertebral discs.Conclusion The semi-rigid lumbar posterior dynamic internal fixation system can achieve an excellent clinical efficacy and prevent and reduce the degeneration of the adjacent lumbar intervertebral discs.