腰椎滑脱复位系统加椎间融合器在成人腰椎滑脱治疗中的应用

Adult Lumbar Spondylolisthesis Treated With Posterior Lumbar Interbodt Fusion Using Fusion Cage Fixation

目的 :通过对 3 2例成人腰椎滑脱症的治疗 ,探讨腰椎滑脱复位系统加椎间融合器在成人腰椎滑脱症中的治疗作用 ,阐述滑脱复位的临床意义。方法 :2 0 0 0年 3月～ 2 0 0 2年 3月 ,我们收治成人滑脱症 3 2例患者 ,其中男 15例 ,女 17例 ;年龄 40～ 67岁 ,平均 5 2岁 ;滑脱类型 ,发育不良伴峡部裂 2 3例 ,退行性 8例 ,创伤性 1例 ;滑脱程度 °～ °,滑脱角最大 10°。临床均有半年以上腰痛、跛行、神经根性症状且保守治疗无效。所有患者均行后路椎体融合术 ,使用腰椎滑脱复位系统加椎间融合器治疗。结果 :本组 3 2例病人随访 3～ 2 4个月 ,平均 12个月 ,所有患者滑脱椎体均维持复位 ,椎体融合良好 ,术后症状消失 2 9例 ,仍有部分症状 3例 ,患者术后症状满意率 90 .6%。结论 :成人腰椎滑脱使用腰椎复位系统加椎间融合器 ,行经腰椎后路椎体间融合术 ,能充分完成后路减压 ,椎体间复位 ,并能保证可靠的融合 。

Objective:To explore the treatment result of abult spondylolisthesis using posterior lumbar interbody fusion and fusion cage fixation.Method:thirty-two patients with lumbar spondylolisthesis underwent posterior lumbar interbody fusion fixation using fusion cage inserted posterolaterally.Patients(40 to 67 years of age )had half a year of back pain,limp,sciatica and a severely restricted functional ability.The inclusion criteria were lumbar spondylolithesis of Ⅰ to Ⅲ grate and the greatest spondylolithesis angle 10°,lumbar isthmic spondylolithesis(n=22),lumbar degenerative spondylolisthesis(n=9),lumbar traumatic spondlolithesis(n=1).Result:All these 32 patients were followed up meanly 12months.The reduction of the spondylolithesis was maintained in all patientd,29/32 patients were excellent,3/32 patients were fair,patient′s satisfactory rate was 90.6%.Conclusion:surgical treatment of adult spondylolisthesis with posterior lumbar interbody fusion using fusion cage is an ideal which enables achieve sufficient posterior decompression,reduction of the deformity and reliable interbody fusion.