无内固定异体骨圈嵌植治疗腰椎滑脱症

Treatment of spondylolisthesis by the allograft fusion ring implantation without internal fixation

目的探讨无内固定异体骨圈前路腰椎椎间融合治疗腰椎峡部裂滑脱症的可行性和安全性。方法用深低温异体骨圈加自体骨嵌植峡部裂腰椎滑脱症15例,不加任何内固定,腰围外固定3个月以上,术后复查X线片观察融合情况、测量椎间隙高度和滑脱椎位移距离差。结果平均随访28个月,融合时间最短8个月,最长13个月;椎间隙高度减低3mm1例,2mm4例;滑椎前移2mm和3mm各1例。按Macnab法评定,优10例,良4例,优良率93.3%。结论齿状异体骨圈加自体松质骨嵌植,无需内固定,治疗腰椎峡部裂Ⅰ°～Ⅱ°滑脱安全可靠,达到复位、稳定、融合的效果。

Objective To investigate the feasibility and safety of operative treatment of spondylolisthesis by anterior lumbar interbody fusion of allograft fusion ring without internal fixation. Methods Specially prepared deeply frozen allograft fusion ring impacted with morselled iliac crest cancellous autografts were implanted into 15 interbody spaces in 15 cases of spondylolisthesis without any internal fixation. Plastic corset as external fixation was applied for at least 3 months. Results 15 cases were followed up for an average of 28 months. Radiographically the duration of bony fusion ranged from 8 to 13 months. Among these, one space lost 3mm height, and four spaces lost 2mm. Spondylolisthesis (slipping forward) of 2mm occurred in one case and 3mm in another. According to Macnab standard, the result was excellent in 10, good in 4. The excellent and good results were 93.3% . Conclusion Operative treatment of spondylolisthesis with teeth shaped allograft fusion ring plus cancellous autografts can successfully restore the spinal structure without additional internal fixation, and obtain good results of reduction, stability and fusion.