保留一侧椎板后路内固定复位椎间、峡部、小关节植骨融合术治疗腰椎滑脱症.docxVIP

保留一侧椎板后路内固定复位椎间、峡部、小关节植骨融合 术治疗腰椎滑脱症 马虎升孙彦鹏史相钦赵庆安（河南省洛阳正骨医院脊柱外科屮心 471002） 【中图分类号】R687【文献标识码】A【文章编号】1672-5085 （2012） 30-0146-03 【摘要】冃的 探讨一侧椎板切除，保留对侧椎板后路椎弓根内固定复位椎间、 峡部、小关节植骨融合术临床疗效和安全性。方法2004年1月至2011年1月 收治腰椎滑脱症并峡部断裂36例，男22,女14例，年龄平均47岁（35?76 岁），均采用“一侧椎板切除，保留对侧椎板后路椎弓根内固定复位椎间、峡部、 小关节植骨融合术”治疗。结果 随访时间平均为18个月（12?24个月），椎 间植骨融合标准参照FDA推荐的Simmons法，36例手术后3~6个月全部骨性 融合。术前腰背部疼痛VAs评分为8.5plusmn;0.4分，术后腰背部疼痛VAS评分 为plusmn;0.2分。结论 一侧椎板切除，保留对侧椎板后路椎弓根内固定复 位椎间、峡部、小关节植骨融合术治疗腰椎滑脫症并双侧峡部断裂临床疗效安全 可靠。 【关键词】腰椎滑脱症 峡部断裂 植骨术 Remaining one of the lamina by pedicle screw fixation and bone graft in intervertebral space vertebral isthmus and facet joints to treat the true spon dylolisthesis. / Mahusheng, Sun Yanpeng,Shi Xiangqin,et al. [Abstract] Objective:To expore the clinic effect and safety of remaining one of the lamina by pedicle screw fixation and bone graft in intervertebral space vertebral isthmus and facet joints. Methods:From January 2004 to January 2011,we treated 36 cases true spondylolisthesis patients ,male 22,female 14, average age of 47 （from 35 to 76）,all of them were treated by remaining one of the lamina by pedicle screw fixation and bone graft in intervertebral space vertebral isthmus and facet joints.Result:The average follow-up time was 18 mon ths （from 12 mon ths to 24 mon ths）,about bone graft in in tervertebra I space ,we used the Simm ons method which recommoned by FDA? All of the 36 cases achieved bony fusion. The average preoperative patientrsquo;s VAs was 8.5plusmn;0.4, The average postoperative patientrsquo;s VAs was l.lplusmn;02 Conclusion: It is a safety and reliable method by remaining one of the lamina by pedicle screw fixation and bone graft in intervertebral space vertebral isthmus and facet joints to treat the true spondylolisthesis which bilateral isthmus fracture. 【Key words］ spondylolisthesis isthmus fracture bone graft 腰椎滑脱症并峡部断裂、下肢疼痛、麻木患者，手术方式有后路腰椎体 间融合术［1、2］、后外侧植骨融合术⑶、后路环状融合术（即后路腰椎体间融合 术和后外侧植骨融合术的联合应用）［4］,其缺点是需要咬除病椎的椎板、棘突、 小关节，植骨融合面仅仅局限在椎体间、小关节外和横突间，为了增加植骨融合