两种不同手术方式在腰椎滑脱症中的对比研究

Application comparison of two different operation methods in lumbar spondylolisthesis

目的探讨经后路植骨融合加椎弓根钉固定与后路植骨融合钉棒系统固定术的疗效，寻找一种更可靠的手术方式。方法对2008年1月至2010年12月在威海市文登中心医院行腰椎滑脱症手术的210例患者进行观察对比，按照随机分配方法随机分为对照组110例和观察组100例。对照组患者行椎弓根固定术，观察组患者行钉棒系统固定术，观察两组手术时间、术中出血量、术后融合率、复位率。术后随访1—2年，参照Macnab标准对比两组患者的治疗效果。结果观察组患者手术时间、术中出血量、术后融合率、复位率明显优于对照组（t=4．55、3．12，X^2=3．11、3．23，P〈0．05），观察组疗效明显优于对照组（X^2=4．55、5．12、5．55、5．13，P〈0．05）。结论后路减压钉棒系统固定植骨融合术在治疗腰椎滑脱的疗效上较椎弓根钉固定更为安全可靠，更适合临床应用。

Objective To compare the efficacy of posterior interbody fusion with pedicle screw fixation and posterior interbody fusion with pedicle screw fixation, and to find a more reliabler operation mode. Methods Two hundred and ten patients from January 2008 to December 2010 underwent the op-eration of lumbar spondylolisthesis were randomly divided into control group anti observation group, 110 patients in control group were treated by pediele fixation, 100 patients in observation group were treated by pedicle screw fixation, the operation time, amount of bleeding after operation, the fusion rate, reduc-tion rate of two groups were compared. After operation, the patients were followed up for 1 - 2 years, ac-cording to the standard of Macnab, the effects of the two groups were compared. Results The operation time, bleeding volume, postoperative fusion operation rate in observation groups were significantly better than those in control group （t =4. 55,3.12 ,X^2 = 3.11,3.23 ,P 〈0. 05 ）, the effect in observation group was better than that in control group （X^2 = 4. 55,5.12,5.55,5.13, P 〈 0. 05 ）. Conclusions Posterior interbodv fusion with pediele screw fixation is more reliable.