腰椎滑脱症:植入物治疗现状及未来发展

Lumbar spondylolisthesis: status and prospects of implant treatment

背景:腰椎滑脱是引起下腰腿疼痛的常见原因之一,是近年来脊柱退行性疾病中的研究热点。目的:腰椎滑脱的手术治疗方法多种多样,文章主要对近几年国内外关于腰椎滑脱症的手术治疗方法进行综述,旨在为腰椎滑脱症的手术方案提供参考。方法:以"腰椎滑脱,椎间融合,内固定治疗,手术治疗,椎弓根螺钉,spondylolisthesis,interbody fusion,internal fixation,operative treatment,pedicle screw"为检索词,分别检索1966年1月至2017年12月CNKI、PubMed数据库中与腰椎滑脱、腰椎滑脱症、脊柱不稳、脊柱侧弯等外科手术治疗相关的文章。根据入选标准及排除标准摘选53篇文献进行综述。结果与结论:(1)腰椎滑脱的外科手术治疗方式多种多样且各具利弊,联合术式往往可以取得相对好的预后结果;(2)手术方式的选择,不仅需要考虑患者的病情需要,也需要考虑术者自身更擅长哪种术式;(3)目前仍没有一种术式能被大家认可,相对于其他术式更具优势。

BACKGROUND:Spondylolisthesis is a most common cause of lumbocrural pain,which has been a hotspot in spinal degenerative diseases.OBJECTIVE:To summarize the surgical methods of lumbar spondylolisthesis at home and abroad,thus providing references for surgical scheme of spondylolisthesis.METHODS:The articles related to the surgical methods of spondylolisthesis,spinal instability and scoliosis published between January 1966 and December 2017 were retrieved from CNKI and PubMed databases.The keywords were“spondylolisthesis,interbody fusion,internal fixation,operative treatment,pedicle screw”in English and Chinese,respectively.Totally 53 eligible articles were enrolled based on the inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1)There are various ways to the surgical treatment of spondylolisthesis and each of them has advantages and disadvantages.Combined surgery can obtain relatively good results.(2)Choosing an operation method not only needs to consider the patient requirements,but also needs to consider what kind of operation is more adept for the surgeons.(3)There is no a surgical method that can be recognized to be superior to the others.