后路椎间融合术治疗两节段双侧峡部裂型腰椎滑脱症的效果分析

Effect of posterior interbody fusion on the treatment of two segments lumber spondylolisthesis caused by bilateral isthmus crack

目的探讨后路椎间融合术治疗两节段双侧峡部裂型腰椎滑脱症的效果。方法 78例两节段双侧峡部裂型腰椎滑脱症患者随机分为2组,给予腰椎后路椎间融合术(PLIF)者为PLIF组,给予后外侧融合术(PLF)者为PLF组,比较2组患者影像学指标、疼痛程度、JOA评分与远期预后。结果 PLIF组患者治疗后椎间高度比、节段前凸角与腰椎前凸角水平均显著性高于PLF组,滑脱率显著低于PLF组(P<0.01)。PLIF组末期随访JOA评分、生理功能评分、躯体疼痛评分与总体健康评分均显著高于PLF组(P<0.01)。结论相比较PLF而言,PLIF对两节段双侧峡部裂型腰椎滑脱症治疗效果更佳。

Objective To investigate the effect of posterior interbody fusion in the treatment of bilateral lumbar isthmic spondylolisthesis in two segments. Methods A total of 78 patients with bilateral isthmic spondylolisthesis were randomly divided into posterior lumbar interbody fusion （PLIF） group and posterolateral lumbar fusion （PLF） group, given posterior lumbar interbody fusion, and posterior lumbar interbody fusion, respectively. The imaging parameters, pain degree, JOA score and long-term prognosis were compared between the two groups. Results The PLIF group had higher intervertebral height ratio, segmental lordosis angle and lumbar lordosis angle than PLF group, and significantly lower slippage rate than PLF group（ P 〈0.01）. The final follow-up JOA score, physical function scores, physical pain scores, and total health scores were significantly higher than that of PLF group （ P 〈0.01）. Conclusion Compared with PLF, PLIF has a better effect on treatment of bilateral isthmic spondylolisthesis in two segments.