有关退变性腰椎滑脱治疗的争议问题

Controversial issues related to the treatment of degenerative lumbar spondylolisthesis

退变性腰椎滑脱(DLS)属于脊柱外科常见疾病,是引起成年人腰腿痛的重要原因之一,严重影响患者的生活质量。临床上DLS主要表现为腰痛、神经根放射性疼痛及间歇性跛行等症状。对于DLS的治疗目前尚未形成统一的标准及认识,临床上存在多个争议点。从DLS治疗过程中存在的保守与手术选择、减压与融合、融合方式的选择、融合是否需要内固定、滑脱是否需要复位以及微创还是开放手术等相关争议问题展开综述,为临床上个性化治疗DLS提供参考。

Degenerative lumbar spondylolisthesis(DLS)is a common clinical disease in spinal surgery.It is one of important causes of low back and leg pain in adults,which seriously affects the quality of life of patients,and often presents a series of clinical symptoms such as low back pain,radiate pain of nerve roots and intermittent claudication.Presently,there are many controversial points in the clinical treatment of DLS,which has not yet formed a uniform standard or recognition.In this paper,we reviewed the relevant literatures in recent years and summarized the related problems during the treatment of DLS such as the choice of conservative or surgical treatment,decompression with/without fusion,the selection of the fusion mode,fusion with/without internal fixation,intraoperative reduction and minimally invasive or open surgery,so as to provide a reference for individualized treatment of DLS in clinical practice.