后路两种内固定装置联合应用治疗腰椎滑脱的临床疗效分析

The Clinical Analysis of Posterior Fixation by Segmental Pedical Screw and Threaded Fusion Cage (TFC) in the Treatment of Spondy-lolisthesis

目的 分析两种内固定联合应用治疗腰椎滑脱是否有效提高临床疗效。方法 对手术治疗的腰椎滑脱135例进行调查,所有病例均采用腰椎后路手术,其中采用单纯植骨融合术21例,采用椎弓根钉固定复位装置加植骨融合术85例,应用椎弓根钉复位装置和螺纹椎体融合器(TFC)联合固定29例。术后随访时间为3个月至3年。结果 应用内固定复位装置的病人术后滑脱复位率、椎间隙高度均明显提高;且术后6个月后,联合内固定装置可有效提高椎体融合率而降低患者腰痛及椎体滑脱复发率。结论 坚强的内固定和有效的椎体融合术是治疗腰椎滑脱的关键,联合内固定为临床治疗腰椎滑脱提供了一条新的、可行的途径。

Objective To analysis the clinic result of posterior fixation by segmental pedical screw and threaded fusion cage (TFC) in the treatment of spondylolisthesis. Methods In this study, 21 patients with spondylolisthesis were managed with direct repair of the defect with auto bone grafts, 85 patients with segmental pedical screw and bone altogether and 29 patients with TFC and pedical screw at the same time. All patients were followed up for 3 month to 3 years after surgery. Results Patients treated by interbody fixation had splendid results in the reduction rate of slippage and the increase of disc hight. Six months after operation fixation by segmental pedical screw and TFC showed an identically low rate of recurrence in low lumber pain and slippage. Conclusion Firmly fixation and effective inter-body fusion play the key role in the treatment of spondylolisthesis. Using segmental pedical screw and TFC as the fixed equipment provide a new and possible way in the therapy of spondylolisthesis.