单纯后路复位减压植骨融合内固定术治疗不同年龄段腰椎滑脱症疗效比较

Comparison of the clinical efficacy of simple posterior reduction and decompression internal fixation with bone graft fusion in the treatment of lumbar spondylolisthesis among different age groups

目的:单纯后路复位减压植骨融合内固定术治疗不同年龄段腰椎滑脱症的临床疗效比较。方法:选择腰椎滑脱病例40例,按年龄分为2组,26~55岁为A组,>55~77岁为B组;均行单纯后路复位减压植骨融合内固定术。结果:40例均获随访,时间6~30个月。A组病人滑脱复位率高于B组(P<0.05),手术时间、出血量、术后VAS评分、术后JOP评分、假关节形成率、硬膜囊损伤率、椎间隙感染率和切口血肿率在2组间差异均无统计学意义(P>0.05)。末次随访2组VAS评分与JOP评分差异亦均无统计学意义(P>0.05)。结论:对于年龄≤55岁的病人应争取将滑脱椎体完全复位,>55岁的病人可不予完全复位,但必须保证神经根松弛,无压迫。

Objective:To compare the clinical efficacy of simple posterior reduction and decompression internal fixation with bone graft fusion in the treatment of lumbar spondylolisthesis among different age groups. Methods:Forty patients with lumbar spondylolisthesis were divided into the group A(aged 26 to 55 years old) and group B(aged 55 to 77 years old).Two groups were treated with simple posterior reduction and decompression internal fixation with bone graft fusion. Results:Forty cases were followed up for 6 to 30 months.The slip reduction rate in group A was higher than that in group B( P <0.05).The differences of the operation time,blood loss,postoperative VAS score,postoperative JOP score,false joint formation rate,dural sac injury rate,intervertebral infection rate and incision hematoma rate between two groups were not statistically significant( P >0.05).The differences of VAS score and JOP score between two groups at the last follow-up were not statistically significant( P >0.05). Conclusions:For patients aged ≤55 years old,the complete reduction of the spondylolisthesis should be achieved.The patients aged >55 years old may not be completely reduced,but the nerve root relaxation and no compression must be guaranteed.