椎间植骨融合加椎弓根螺钉内固定治疗腰椎滑脱.pdfVIP

452 Chi — — nese Journal of Modern Operative Surgery，Dec．2007，Vo1．11．No．6 · 临 床 论 著 · [文章编号]1009—2188(2007)06—0452—03 椎间植骨融合加椎弓根螺钉内固定治疗腰椎滑脱 孔金海，康意军 (中南大学湘雅二医院骨科，长沙410011) [摘要] 目的 探讨椎间植骨融合联合椎弓根螺钉内固定治疗腰椎滑脱症的效果。 方法 114例腰椎滑脱患者采用后路椎弓根螺钉复位固定加椎间植骨融合术。 结果 平均手术时间(267± 23)min，出血量(915±175)ml，术中无神经、输尿管及大血管损伤等严重并发症。平均随访17．9(9 48)个月。椎间植骨融合率95．6％，融合时间平均9．3(3．5～6．5)个月，未融合5例。椎间隙高度维持 良好，滑脱椎体复位无丢失。疗效评价：优73例，良29例，可9例，差3例，优良率为89．5％。 结论 椎间植骨融合加椎弓根螺钉内固定是治疗腰椎滑脱症的一种有效措施。 [关键词] 脊柱前移； 椎间植骨融合术 【中图分类号]R681．5 [文献标识码]B Lumbar Interbody Fusion Combined Pedicle Screws Fixation in the Treatment of Lum bar Spondylolis． thesis KONG Jin—hai，KANG Yi n (Department of Spine Surgeo，Second Xiangya Hospital，Central South UniversiO ，Changsha 410011，Hunan，China) Abstract： Objective To explore the outcomes of lumbar interbody fusion combined pedicle screws fixa— tion in the treatment of spondylolisthesis． Method After repositioned by the pedicle screws，1 14 patients un— derwent lumbar interbody fusion． Results The mean operation time was(267±23)minutes，and the mean bleeding volume was(915±175)m1．No severe complication such as injuries of nerve，ureter，or great vessel was observed．All were followed up for average 17．9(9～48)months．The bone union rate of was 95．6％ within average 9．3(3．5—6．5)months．The intervertebral space keptⅦeU and there was no angle lost after re— position．There were 73 of good，29 of fine．9 of fair and 3 of worse．The good and fine rate was 89．5％．Con- clusion The lumbar interbody fusion combined pedicle screws fixation is an effective method in the treatment of the lumbar sp0ndylolisthesis． Key words： spondylolisthesis； lumbar interbody fusion 引起腰椎滑脱的常见原因有退行性病变及峡部 一 75)岁。退变性滑脱73例，峡部裂性滑脱41例。 裂，常见合并症有腰椎管狭窄及腰椎间盘突出，目前 术前常规行腰椎正侧位、左右斜位及动力位摄片和腰 公认的治疗方法是滑脱椎体