后路椎弓根螺钉内固定加椎间植骨融合治疗腰椎滑脱41例临床疗效

Clinical effect of posterior transpedicular screw fixation combined with intervertebral bone grafting fusion on 41 cases of lumbar spondylolisthesis

目的探讨后路椎弓根螺钉内固定加椎间植骨融合治疗腰椎滑脱临床疗效。方法对41例腰椎滑脱患者行Cage椎间植骨融合结合钉棒内固定系统手术治疗，使用JOA下腰痛手术评价系统评定临床症状的改善情况，影像学评价椎间隙高度、椎体滑脱距离、滑脱角度的改变及椎间融合情况。结果对41例患者随访6—30（16±2）个月，未发生感染及神经根损伤，x线片检查未见椎弓根螺钉内固定系统松动、断裂或移位，所有患者均达到骨性愈合，植骨融合率为100％。末次随访时按照JOA评定标准：优33例，良5例，优良率为92．7％。患者术后1、6个月JOA评分、椎间隙高度、滑脱距离及滑脱角度与术前相比，差异有统计学意义（P〈0．05）。结论后路椎弓根螺钉内固定加椎间植骨融合治疗腰椎滑脱操作简便，固定牢靠，椎间融合率高。

Objective To study the clinical effect of posterior transpedicular screw fixation combined with intervertebral bone grafting fusion in the treatment of lumbar spondylolisthesis. Methods A total of 41 patients with lumbar spondylolisthesis were treated with the technique of Cage interbody fusion and internal nail-stick fixation system. Moreover, iconography was adopted to measure the height of intervertebral space, lumbar spondylolisthetic distance, change in slip angle and intervertebral fusion. Results During 6 - 30 （ 16 ＋ 2 ） months＇ follow-up, there was no infection or nerve root injury, and the radiological evaluations showed no failure in the internal fixation. All of them were successful in fusion, with a fusion rate of 100%. According to JOA standard, the outcomes were excellent in 33 and good in 5 cases, with a rate of 92.7%. JOA score, height of intervertebral space, slip distance and angle after 1 and 6 month （s） were of statistically significant difference from that before operation （ P 〈 0.05 ）. Conclusion The operation of posterior transpedicular screw fixation combined with intervertebral bone grafting fusion in the treatment of lumbar spondylolisthesis is simple and the fixation is reliable.