BAK后路椎间融合治疗腰椎滑脱症

Spondylolisthesis Treated by Posterior Lumbar Interbody Fusion with BAK: A Report of 38 Cases

目的探讨BAK在治疗腰椎滑脱症的临床应用。方法对 38例腰椎滑脱病例进行回顾性分析。 2 2例腰椎Ⅰ度滑脱行BAK后路原位椎间融合 ;16例腰椎Ⅱ度滑脱病例用单枚BAK后路斜向椎间融合 +椎弓根螺钉内固定。结果术后随访 1～ 5年 ,平均 2 .5年。椎体间植入物均融合。病人术后症状都有明显改善。优良率为 95 %。结论对腰椎Ⅰ度滑脱和Ⅱ度滑脱应采用不同的治疗方法。对腰椎Ⅰ度滑脱单纯行BAK后路原位椎间融合 ;对腰椎Ⅱ度滑脱用单枚BAK后路斜向椎间融合+椎弓根螺钉内固定 ,有利于脊柱的稳定、滑脱的复位和生理前凸的维持 ,符合腰椎生物力学的要求。

ObjectiveTo explore the clinical application of BAK in lumbar spondylolisthesis.MethodsThirty-eight cases of lumbar spondylolisthesis were analyzed retrospectively, 22 cases classified as grade Ⅰ were operated by posterior lumbar interbody fusion with two BAKs, the other 16 cases with grade Ⅱ were operated by one BAK and pedicle screw system. Results The follow-up period extended from 1 year to 5 years, on the average for 2.5 years. All of 38 patients were observed and their preoperative symptoms were significantly improved. All of them achieved successful fusion and the bone union rate was 100%. Their clinical excellence rate was 95%.ConclusionsTreatment for lumbar spondylolisthesis classified as grade Ⅰ and Ⅱ should be different. Those classified as grade Ⅰ were operated by posterior lumbar interbody fusion with two BAKs, whereas grade Ⅱ were operated by one BAK and pedicle screw system, Application of the latter operative method has the advantage of stabilizing lumbar spine, facilitating the reduction of spondylolisthesis and maintaining the normal lordosis of lumbar spine. It can fulfill the requirements for biomechanics of lumbar spines.