三种入路椎间融合术治疗下腰椎退行性滑脱比较

The treatment for lumbar spondylolisthesis with three surgery methods:a comparison study

目的比较椎弓根螺钉内固定分别联合前路椎间融合术、后路椎间融合术、椎间孔入路椎间融合术治疗下腰椎退行性滑脱的适应证以及临床疗效。方法回顾性分析我院2006～2010年收治的下腰椎退行性滑脱患者98例,其中29例行前路椎间植骨融合术+椎弓根螺钉内固定(A组)、35例行后路椎间融合术+椎弓根螺钉内固定(B组)、34例行椎间孔入路椎间融合术+椎弓根螺钉内固定(C组),并进行随访1年,对三组患者的手术疗效、植骨融合率、椎间隙高度以及手术前后疼痛VAS评分和Oswestry功能障碍指数(ODI)进行比较。结果随访1年后,B、C组在ODI、VAS评分方面显著好于A组(P<0.05),B和C组不存在差别,C组在术后椎间隙高度上显著好于A组和B组,三组在术后融合率方面不存在统计学差异。结论椎间孔入路椎间融合术联合椎弓根螺钉内固定是治疗腰椎退行性滑脱的理想术式。

Objective To compare the effect of treatment for lumbar spondylolisthesis by ALIF, PLIF and TLIF. Methods Retrospective analysis the clinical data of 98 patients with lumbar spondylolisthesis, 29 for ALIF （group A）, 35 for PLIF （group B） and 34 for TLIF （group C）, all patients were followed-up for 1 year, and the effect, fusion rate, intervertebral height and scores of ODI and VAS were compared. Results Groups B,C had significant differences in scores of OID and VAS than A and C （P 〈 0.05）, and there was no difference in fusion rate. Conclusion TLIF is a safe and effective method in the treatment of lumbar spondylolisthesis.