腰椎附件结构性骨块植骨内固定治疗腰椎滑脱症疗效观察

Curative Effect of Structural Auto-graft of Lumbar Vertebrae Appendage with Internal Fixation on Lumbar Spondylolisthesis

目的探讨腰椎自体附件结构性植骨治疗腰椎滑脱症的有效性及可行性。方法 102例腰椎滑脱症患者,术中后路椎管减压切除腰椎棘突、椎板及关节突等附件骨,并将其回植椎间隙,作椎弓根螺钉内固定。术后随访1-10年（平均6.5年）,随访患者症状缓解程度、椎间植骨融合情况、JOA评分、VAS评分、并发症,并作患者满意度调查。结果 102例患者症状均有缓解。术后、术后1年及最终随访时临床恢复率分别为80.30%、85.80%和85.10%。在术后3、6、12月患者融合率分别为26.5%、81.2%、97.9%。患者满意率达97.9%。结论腰椎附件结构性植骨生物融合能力及支撑能力可以满足临床需要,腰椎附件结构性植骨内固定治疗腰椎滑脱症可以取得满意疗效。

Objective To discuss the effectiveness and feasibility of structural auto-graft of lumbar vertebrae appendage in the treatment of lumbar spondylolisthesis. Methods 102 cases with lumbar spondylolisthesis were enrolled; posterior lumbar canal decompression was performed, as well as the resection of spinous process, vertebral lamina and articular process, which were replanted into the intervertebral space and fixed with pedicle screw; follow-up lasted from 1 year to 10 years with the average of 6.5 years, symptom relief, fusion, JOA scores, VAS scores, complications and the patient satisfaction were observed. Results Symptom relief was found in all the 102 cases; the clinical recovery rate at the time point of after surgery, 1 year after surgery and at the last follow-up was 80.30%, 85.80% and 85.10% respectively; the fusion rate at the time point of 3, 6 and 12 months after surgery was 26.5%, 81.2% and 97.9% respectively; the patient satisfaction reached 97.9%. Conclusions The biological fusion and supporting ability of structural auto-graft of lumbar vertebrae appendage can meet the need in clinic and structural auto-graft of lumbar vertebrae appendage with internal fixation is of satisfactory effect on lumbar spondylolisthesis.