多节段腰椎滑脱手术治疗新术式探讨

Surgical Treatment of the Multi-segmental Stair-like Lumbar Spondylolysis

目的 :探讨一种新的使用RF系统及BAK融合器治疗多节段腰椎滑脱的手术方法。方法 :①常规后路彻底减压 ;②利用RF系统对下位滑脱椎体进行复位后植入一对BAK融合器 ;③同法对上位滑脱椎体进行复位后植入另外一对BAK融合器 ;④再次利用RF系统进行适当加压。结果 :采用本手术方法治疗 2例腰 4、5双节段腰椎滑脱患者 ,滑脱完全复位 ,临床症状消失 ;术后 3个月和 5个月随访临床症状和滑脱无复发。结论 :后路减压利用RF系统行一期分段复位加椎体间BAK植入融合治疗多节段阶梯状腰椎滑脱 ,手术方法简单 ,手术一期完成 ,能恢复脊柱解剖连续性及腰骶部生物力学功能 ,重建脊柱稳定性 ,优于其它手术方法。

Objective:To introduce a new surgical procedure for the multi segmental stair like lumbar spondylolysis using RF system combined with BAK cages. Methods: Firstly,posterior decompression was conducted as usual. Secondly,reduction of the lower vetebra was carried out and fixed with a pair of BAK cages. Thirdly,reduction of the upper vertebra was done in the same way;and finally,decompression of the reductioned segments was conducted again with the RF system. Results:Two cases of dual segmental lumbar spondylolysis were treated with this procedure and complete reduction was achieved. The 3 and 5 months follow ups showed no recurrence. Conclusion: This procedure is simple and effective in the treatment of multi segmental lumbar spondylolysis.