经椎弓根内固定器械治疗腰椎滑脱症57例

Treatment of vertebrae spondylolisthesis with pedicle screw system

总结应用经椎弓根内固定器械治疗腰椎滑脱症57例，比较两种治疗方法的优缺点．方法：应用Steffee钢板法33例，RF技术24例．手术方式采用全椎板减压、器械复位固定、小关节突横突植骨或椎体间植骨融合．结果：随访43例，优19例，良ZO例，可4例，优良率达9o．7％，滑脱椎体平均复位率：Steffee73．4％，RF9o．8％．结论：经椎弓根内固定是治疗腰椎滑脱的有效方法；在滑推复位率上RF优于Steffee钢板；植骨融合方式上以推体间植骨较为理想．

A1M: To review our experience in patients withspondylolisthesis treated by pedicle screw system and to com-pare the effectiveness between Steffee and RF devices-METHODS: From January 1992 to December l998, 57 pa-tients with spondylolisthesis were treated with the followingmethods: directive decompression towards to the compress6dlesion area to relieve the compression factors; reduction andfixation for s1ipped vertebrae with Steffee or RF device to re-store the normal anatomical curve of the vertebrae; posteriorzygapophysical joints fusion or posterior lumbar interbody fu-sion (PLIF) per formed by implanting autograft iliac bones.The follow up period was from lO to 84 months with an aver-age of 4o months. RESULTS: Excellent results were ob-tained in 19 cases, good in 2O cases, and fair in 4 cases- Nocases of poor results were found. The clinical success ratewas 9O. 7%. The reduction rate of RF device and Steffee de-vice was 9O. 8% and 73. 4% respectively. CONCLUSION:Application of posterior lumbar interbody fusion (PLIF) andpedicle screw fixation has the advantage of stabilizing bothanterior column and posterior column of lumbar spine. RFdevice is better than Steffee in facilitating the reduction ofspondylolisthesis.