Cage植骨联合椎弓根螺钉内固定融合治疗腰椎滑脱的疗效观察

Cage bone graft combined with pedicle screw fixation fusion in treatment of lumbar spondylolisthesis

目的研究不同入路Cage植骨联合椎弓根螺钉内固定融合治疗腰椎滑脱的临床疗效。方法将2011年1月至2012年12月我院收治的120例腰椎滑脱患者按手术方式分为前路椎体间植骨融合术(ALIF)组和后外侧植骨融合术(PLF)组、经后路椎体间植骨融合术(PLIF)组,每组40例,观察手术相关指标及远期机体功能情况。结果 PLIF组患者的手术时间为(82.3±12.1)h,术中出血量为(60.3±9.5)mL,术后下床活动时间为(5.5±0.7)d,NRS评分为(1.5±0.2)分,术后3、6、9、12个月后的ODI评分分别为(24.1±3.4)分、(19.4±3.1)分、(13.5±2.5)分、(9.8±1.6)分,各项指标均明显低于ALIF组和PLF组,PLIF组椎间隙高度(9.3±1.2)mm,明显大于ALIF组和PLF组(P<0.05)。结论经后路椎间植骨融合术能够减小手术创伤,促进术后恢复,改善远期机体功能,在腰椎滑脱的治疗中具有积极价值。

Objective To study the effect of different approaches of Cage bone graft combined with pedicle screw fixation fusion in trea- ting lumbar spondylolisthesis. Methods From January 2011 to December 2012,120 patients with lumbar spondylolisthesis in our hospital were randomly divided into anterior lumbar interbody fusion （ALIF） group（ n = 40 ） , postero lateral fusion （PLF） group （n = 40） and posteri- or lunbar interbody fusion （PLIF） group（n =40）. The related index and body＇ s function were observed. Results In PLIF group,the opera- tion time was（ 82.3 ± 12.1 ） h,intraoperative bleeding volume was （ 60.3 ± 9.5 ） mL, postoperative ambulation time was （ 5.5±0. 7 ） d, NRS score was （ 1.5 ± 0.2 ）, ODI score 3,6,9,12 months after operation were respectively （ 24. 1 ± 3.4 ）, （ 19.4 ±3.1 ）, （ 13.5 ± 2.5 ）, （9.8± 1.6） ,which was significantly lower than ALIF group and PLF group;the intervertebral height（9.3 ±1.2） mm were significantly high- er than those of ALIF group and PLF group. Conclusion PLIF has positive clinical value in treating lumbar spondylolisthesis as it can re- duce the operation wound, promote postoperative recovery, and improve the long-term function of body.