后路复位固定椎间植骨融合治疗腰椎滑脱

Posterior Reduction and Fixation with Inter - body Fusion for Lumbar Spondylolisthesis

目的 探讨后路复位固定椎间植骨融合治疗腰椎滑脱的疗效及其适应证。方法 选择11例有严重神经根症状的腰椎滑脱症患者采用后路全椎板减压、Steffee钢板复位固定、椎间植骨融合手术,观察复位情况、融合率、客观疗效评价、并发症等。结果 随访时间12～36个月,完全复位8例,部分复位2例,原位融合1例。全部患者均获得骨性融合。疗效评价:优8例,良2例,可1例。并发症:术后发生对侧神经根疼痛2例。结论 有严重神经根症状的腰椎滑脱建议充分减压,尽可能复位。椎间植骨融合率高。结合Steffee钢板具有较好的复位固定作用。

Objective To evaluate the effectiveness and indications of posterior reduction and fixation with inter- body fusion. Methods Eleven patients with spondylolisthesis, who had severe radicular symptoms, were reviewed. The procedures involved decompression, reduction and fixation with Steffee plate or RF Ⅱ fixator as well as inter- body fusion. The degrees of reduction, fusion rate and complications after surgery were carefully analyzed. Results After a follow- up of 12 to 36 months, it was shown that a solid bony fusion was achieved in all cases. Among them, complete reduction was achieved in 8 cases and incomplete in 2 cases exept a patient who had a fusion at site. According to clinical evaluation, 10 cases were excellent and one fair. The only posle - opetative complrcal was contralat-eral nevralsia and seen in two cases. Conclusion It was suggested that the cases of spondylolisthesis with severe radicular symptoms should be decompressed fully and fixed absolutely. Utilizing spinal plate, a good reduction and fixation would be achieved.