后路经椎间孔椎体间融合术临床应用(附21例报告).docVIP

后路经椎间孔椎体间融合术临床应用(附21例报告) 　　【摘要】 目的 探讨后路经椎间孔椎体间融合术进行腰椎滑脱治疗的效果。方法 自 2006 年5 月至 2009 年 5 月，对 21 例(23 节段)腰椎滑脱患者进行TLIF手术，患者包括男 7 例，女14 例；年龄 42~67 岁，平均 53?6 岁，根据Meyerding分级标准，Ⅰ 度滑脱 7 例，Ⅱ 度滑脱 14 例，术中选择采用Sofamor Danek 公司TENOR、CDHM8或BASIS内固定系统，Sofamor Danek 公司TELAMON或钛网，或CAPSTONE Peek材料融合器，术后随访包括JOA腰背痛评分标准评分、常规X线摄片、CT扫描。结果 21 例患者平均随访时间 26?5 个月，无一例出现感染、断钉、椎间融合器下沉、后移等并发症，1 例术后出现神经症状，经药物治疗后好转。手术腰椎节段不同程度融合，椎间隙高度、椎体滑移距离、腰椎前突弧度不同程度改善，融合率为 90?5%,腰背痛评分统计：术前 (14?8±4?2) 分，术后 (24?9±3?5) 分， 差异有统计学意义（P 　　【关键词】 　　腰椎滑脱； 后路椎体间融合； CT 　　Clinical application of transforaminal lumbar interbody fusion：feport of 21 cases 　　ZHANG Xi?feng, LI Qiang, YANG Zong?hua, et al.Department of Orthopedic, The Second People’s Hospital of Changshu city, 　　Jiangsu 215500，China 　　【Abstract】 Objective To investigate the treatment of spondylolisthesis with transforaminal lumbar interbody fusion? Methods From May 2005 to May 2009, 21 cases (23 levels) including 7 males and 14 females suffering from spondylolisthesis were treated with TLIF? The average age of the patients in this study was 53?6 (from 42 to 47)? In operations internal fixation systems used were TENOR or CDHM8 or BASIS from the Sofamor Danek company, and internal fusion were TELAMON or titanium mesh cage or CAPSTONE Peek from the Sofamor Danek company? The change in the Japanese Orthopedics Association score, the recovery rate, and radiographic findings were evaluated? Results All cases were followed up for 12~47 months (26?5 months on average) with the fusion rate of 90?5%?There were no severe complication except thatsymptom of nerve injury in one case who recovered after treatment with neurotrophy? Translational distance were restored from (5?9±3?3) mm preoperatively to (2?3±1?6)mm postoperatively? Respectively the JOA scores were (14?8±4?2) points preoperatively, and after surgery increased to (24?9±3?5) points? Conclusion TLIF is a safe and reliable and minimally invasive technique, and CT images are used to evaluate simply and effectively