椎间融合器加椎弓钉系统治疗腰椎滑脱症疗效分析

Analysis of effects of treating lumbar spondylolisthesis with TriFix reduction rod system and intervertebral fusion Vigor Spacer

目的 探讨后路腰椎管减压、椎弓钉系统复位、Vigor Spacer椎间融合器和小关节突间植骨治疗腰椎滑脱并腰椎管狭窄的临床疗效。方法 对37例腰椎滑脱患者进行腰椎管减压、椎弓钉系统复位内固定、Vigor Spacer椎间融合器和小关节突间植骨的手术治疗。其中波滑脱27例,Ⅱ度滑脱10例;L_(4,5),滑脱12例,L_5 S_1滑脱15例;23例为峡部裂性,14例为退行性。结果 随访10～38个月,平均23.6个月。通过对术前术后临床症状和X线片滑脱复位程度比较,37例中33例症状完全消失,优良率89.2％;27例Ⅰ度滑脱完全复位,10例Ⅱ度滑脱8例完全复位,椎间融合率97.3％;椎间高度由术前平均4.1mm恢复至术后11.7mm,且无高度丢失。结论后路减压、椎弓钉系统复位内固定、Vigor Spacer椎间融合器和小关节突间植骨治疗腰椎滑脱,效果良好,复位稳定满意。

Objective To investigate the clinical outcome of lumbar spondylolisthesis with decompressive laminectomy, RF-Ⅱ instrumentation, posterior interbody fusion Vigor Spacer and intertransverse process arthrodisis bone grafting. Methods 37cases of lumbar spondylolisthesis with decompressive laminectomy, fixed with RF-Ⅱ instrumentation, posterior installed with interbody fusion Vigor Spacer and bone grafted between inter-transverse process arthrodisis from June 1999 to June 2002. 27 cases were classified as degree Ⅰ ,the rest degree Ⅱ . The levels of spondylolisthesis between L4 and L5 covers 12 cases,between L5 and S1 does 15 cases. Results The cases were followed up from 10 to 38 months with average 23.6 months. The results showed that the primary symptoms disapeared completely in 33 of 37 cases, pain relief was 89.2% . 27 cases with degree Ⅰ and 8 of 10 cases with degree Ⅱ obtained complete reduction, intervertebral hight increased from 4.1 mm to 11.7 mm and kept unchangeably, 97.3 % of them fused well. Conclusion Treatment of lumbar spondylolisthesis with decompressive laminectomy, RF- Ⅱ instrumentation, posterior interbody fusion Vigor Spacer and bone grafting has excellent clinical results and stable reduction.