后路环状融合术在腰椎滑脱症外科手术中的应用

《后路环状融合术在腰椎滑脱症外科手术中的应用》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、后路环状融合术在腰椎滑脱症外科手术中的应用【摘要】探讨后路环状融合术（PCF）联合短节段椎弓根螺钉系统内固定治疗腰椎滑脱症（LSL）的可行性、方法及临床疗效。［方法］从2002年10月~2006年3月，对44例LSL患者采用腰椎管减压、环状植骨融合及短节段椎弓根螺钉内固定手术进行治疗。男15例，女29例；年龄31~68岁，平均486岁。所有患者术前均经X线和CT证实为腰椎滑脱合并椎管狭窄。按Newman分型：退变性滑脱15例，峡部裂性滑脱29例。按Meyerding分级：Ⅰ度滑脱17例，Ⅱ度滑脱24例，Ⅲ度滑脱3例。L4、

2、5滑脱18例，L5S1滑脱26例。［结果］全部病例随访18~36个月，平均26个月。17例Ⅰ度滑脱术后全部解剖复位；24例Ⅱ度滑脱中6例遗留Ⅰ度滑脱；3例Ⅲ度滑脱中2例遗留Ⅰ度滑脱。根据侯树勋临床疗效评价标准，优28例，良13例，可3例，优良率达932%。无内固定松动断裂和神经根与马尾神经损伤并发症。术后3~10个月植骨均获骨性愈合，平均42个月。随访期间椎间隙高度维持良好，滑脱椎体复位无丢失。［结论］PCF联合短节段椎弓根螺钉系统内固定是治疗LSL的一种可靠方法，能够提高脊柱的融合率并维持良好的椎间隙高度和形态及腰椎生

3、理性前凸。满意的临床效果依赖于全面掌握PCF和短节段椎弓根螺钉固定的技术特点。【关键词】腰椎滑脱症椎管减压后路环状融合术椎弓根螺钉系统11Abstract［Objective］Toevaluatethefeasibilitiy,methodsandtherapeauticaleffectsoftheposteriorcircumferentialfusion(PCF)combinedwithshort-segmentalpediclescrewsystemfixationforthetreatmentoflumbarspon

4、dylolisthesis(LSL)［Method］FromOctober2002toMarch2006,44casesofLSLweretreatedwithdecompressionforspinecanalstenosis,circumferentialfusionandshort-segmentalpediclescrewsystemfixationTherewere15maleand29female,averageagewas486(ranged,31~68)yearsThediagnosesofLSLan

5、dstenosiswereconfirmedbyX-rayandCTAccordingtoNewmanclassification,15ofthemwerethedegenerativetypeand29wereisthmictypeAccordingtoMeryerdingclassificationofLSL,17patientshaddegreeI,24patientshaddegreeⅡand3patientshaddegreeⅢspondylolisthesisThelevelsofLSLwasbetween

6、L4andL5,in18patientsandbetweenL5andS1in26cases［Result］Thefollow-upperiodwas18~36months,averaged26monthsSeventeenpatientswithdegreeⅠspondylolisthesiswereallreducedanatomicallyaftersurgeryTwenty-fourpatientswithdegreeⅡspondylolisthesiswerereducedanatomicallyexcept

7、for6patientswithⅠdegreeresidualspondylolisthesis311patientswithdegreeⅢspoadylolisthesiswerereducedanatomicallyexceptfor2spatientswithⅠdegreeresidualspondylolishesisTheeffectwasevaluatedaccordingtoHouShuxun’sevaluationstandard,theresultswereexcellentin28cases,good

8、in13cases,andfairin3casesTheexcellentandgoodratewas932%Nocomplicationsuchasinterfixationfailureandnervepedicleinjuryorcaudaequineinjurywerefou