后路椎间隙撑开复位联合椎弓根螺钉提拉复位椎间植骨融合治疗Ⅰ、Ⅱ度腰椎滑脱症

Posterior Intervertebral Space Distraction Reduction, Pedicle Screw Elevating-pulling Reduction and Intervertebral Bone Graft and Fusion for the Treatment of I ~ or ]] ~ Lumbar Spondylolis-thesis

【目的】探讨后路椎间隙撑开复位联合椎弓根螺钉提拉复位椎间植骨融合治疗I、Ⅱ度腰椎滑脱的临床疗效。【方法】回顾性分析本院2008年5月至2010年5月39例腰椎滑脱患者行后路椎间隙撑开复位联合椎弓根螺钉提拉复位椎间植骨融合术的病例临床资料，根据下腰痛JOA评分和影像学结果，评价临床疗效。【结果】全部病例腰背疼痛完全解除或者有明显缓解，按JOA评估标准，术前JOA评分（11．76±1．42）分，末次随访时JOA评分（23．49±1．92）分，改善率67．98％。滑脱完全复位率为97．4％（38／39），植骨融合良好，无内固定松动和Cage下沉及移位。按侯树勋的临床疗效评定：优35例，良2例，可2例，差0例，优良率为92．8％。【结论】后路椎间隙撑开复位联合椎弓根螺钉提拉复位椎间植骨融合术能发挥撑开、提拉复位和融合的双重作用，创伤小，是治疗腰椎滑脱症的安全、有效方法之一。

[Objective] To explore the clinical efficacy of posterior intervertebral space distraction reduction, ped- iele screw elevating-pulling reduction and intervertebral bone graft and fusion for the treatment of I~ or lI~ lumbar spondylolisthesis. [Methods] The clinical data of 39 patients with I~ or If~ lumbar spondylolisthesis undergoing poste- rior intervertebral space distraction reduction, pedicle screw elevating-pulling reduction and intervertebral bone graft and fusion from May 2010 to May 2010 in our hospital were analyzed retrospectively. According to JOA score of low back pain and radiological results, the clinical efficacy was evaluated. [Results]Marked or complete pain relief was a- chieved in all patients with lumbar and back pain. By JOA evaluation criteria, the preoperative JOA score was 11.76 -t-1.42 points, and the last follow-up JOA score was 23.49_--4-1.92 points. The improvement rate was 67.98%. The complete reduction rate of spondylolisthesis was 97.4~ （38/39）. The bone graft and fusion was good. No fixation loose and Cage subsidence and movement occurred. Based on Hou Shu-xun criterion for therapeutic evaluation, 35 ca- ses were excellent, and 2 cases were good, and 2 cases were fair, and no case was bad. The excellent and good rate was 92.8 ~. [Conclusion]Posterior intervertebral space distraction reduction, pedicle screw elevating-pulling reduction and intervertebral bone graft and fusion can play the dual role of the distraction, elevating-pulling reduction and fu- sion, and has minimal invasion, so it is one of safe and efficient surgical methods for the treatment of lumbar spon- dylolisthesis.