TLIF联合单侧开窗加内固定术治疗腰椎滑脱疗效分析

Combination of unilateral open decompression and transforaminal lumbar interbody fusion with pedicle screw fixation in treatment of spondylolisthesis

目的探讨采用椎间孔腰椎体间融合(TLIF)联合单侧开窗加双侧椎弓根内固定术治疗腰椎滑脱的疗效。方法 2007年3月—2013年1月我中心共收治32例腰椎滑脱患者,均采用TLIF联合单侧开窗加双侧椎弓根内固定术进行治疗。术后采用腰椎JOA疗效评定标准对疗效进行评价。结果 32例均获术后随访,术后X线片示32例患者椎间基本达到骨性融合,融合率达96%,滑脱椎体复位率为85%。末次随访时按腰椎JOA疗效评价标准的结果:优20例,良11例,差1例。结论该项技术适合治疗Ⅰ、Ⅱ度腰椎滑脱患者,具有手术创伤小、时间短、腰椎滑脱椎体复位好、腰椎稳定且破坏少、疗效确切等优点。

Objective To investigate the clinical outcomes of the combination of unilateral open one-level lumbar decompression and transforaminal lumbar interbody fusion（ TLIF） with bilateral pedicle screw fixation in the treatment of patients with spondylolisthesis. Methods From March 2007 to March 2013,32 patients with spondylolisthesis were treated with the combination of hybrid techniques. The postoperative effect was evaluated by Asberos system. Results All the 32 patients were followed up. The postoperative radiographic outcomes showed that almost all the patients achieved solid fusion with a fusion rate of 96% and a reduction rate of 85%. At the last follow up,according to Asberos system the results were excellent in 20,good in 11,and poor in 1 case（ s）.Conclusion The hybrid techniques demonstrate the major advantage for the patients with grade Ⅰ and Ⅱ spondylolisthesis,with less invasion,shorter surgical time,good reduction and so on.