腰椎退行性滑脱不同治疗方法的疗效分析

Comparative study of five methods for the treatment of lumbar degenerative spondylolisthesis

目的 探讨五种不同方法治疗腰椎退行性滑脱症的疗效。方法 6 3例患者中采用保守治疗 (A) 3例 ,椎管减压术 (B) 2 5例 ,椎管减压加Hartshill框架复位固定“H”型植骨融合术 (C) 12例 ,椎管减压加Dick钉复位固定横突间植骨融合术 (D) 10例 ,椎管减压加Steffee钢板复位固定椎体间植骨融合术 (E) 13例。结果 随访 3个月至 10年 ,平均 12 5个月 ,根据疗效评定标准 ,A、B、C、D、E五种方法的优良率分别为 6 6 7% ,92 0 % ,41 7% ,70 0 %和 92 3%。结论 保守治疗对大多数患者有效 ;稳定型患者在彻底减压的基础上应尽可能地保留脊柱后柱的稳定结构 ;

Objective*'To compare clinical results of five methods for the treatment of lumbar degenerative spondylolisthesis Methods*'Of 63 patients with lumbar degenerative spondylolisthesis,3 cases were treated with conservative treatment (A),25 with decompression of spinal cord (B),12 with decompression of spinal cord combined with reduction and fixation of Hartshill frame and fusion with 'H' graft (C),10 with decompression of spinal cord combined with reduction and fixation of Dick nail and fusion of bone intratransverse process (D),13 with decompression of spinal cord combined with reduction and fixation of Steffee plate and fusion of bone intravertebral (E).Results*'The follow up period ranged from 3 months to 10 years,with an average of 12 5 months.According to the curative effect evaluation cirterion,the excellent and good rate of the A,B,C,D and E five methods were 66 7%,92 0%,41 7%,70 0% and 92 3% respectively.Conclusion*'The conservative treatment method is effective in treating most patients with lumbar degenerative spondylolisthesis.During the operation,the stability of spinal posterior column should be remained as much as possible on the basis of complete decompression for the patient of stable type.Of the three internal fixation apparatus,the Steffee plate is most suitable for reduction and fixation of lumbar spondylolisthesis.