| 后外侧植骨融合椎弓根螺钉内固定治疗退变性腰椎滑脱症 |
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投稿时间：2010-03-01
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| 作者 | Author | 单位 | Address | E-Mail |
| 陈可新 |
CHEN Ke-xin |
河南省洛阳正骨医院,河南 洛阳 471002 |
Luoyang Orthopaedics Hospital,Luoyang 471002,Henan,China |
kexin_1221@163.com |
| 杨启友 |
YANG Qi-you |
贵阳医学院附属医院骨科 |
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| 刘兴才 |
LIU Xing-cai |
河南省洛阳正骨医院,河南 洛阳 471002 |
Luoyang Orthopaedics Hospital,Luoyang 471002,Henan,China |
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| 李宏九 |
LI Hong-jiu |
河南省洛阳正骨医院,河南 洛阳 471002 |
Luoyang Orthopaedics Hospital,Luoyang 471002,Henan,China |
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| 期刊信息：《中国骨伤》2010年，第23卷，第4期，第254-256页 |
| DOI：10.3969/j.issn.1003-0034.2010.04.006 |
| 基金项目: |
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中文摘要:
目的：探讨加用椎弓根螺钉内固定能否改善后路减压、后外侧植骨融合治疗退变性腰椎滑脱症的临床疗效及其应用意义。
方法：自1998年12月至2005年12月采用手术治疗退变性腰椎滑脱症49例，男12例，女37例；年龄49～68岁，平均58.5岁。Meyerding分型：Ⅰ度32例，Ⅱ度17例。其中21例采用后路减压、后外侧植骨融合治疗(A组),28例加用CD HORIZON M8椎弓根螺钉内固定系统(B组).术前两组患者的疼痛程度和功能障碍无统计学差异。49例患者均获得随访，时间12～90个月，平均58个月。参照Yuan等标准对疗效进行评价，评价内容包括腰腿痛程度(VAS评分)、脊柱活动功能和神经功能。
结果：随访时腰痛VAS评分：A组(41.9±7.5)分，B组(32.8±6.2)分；腿痛VAS评分：A组(33.9±7.3)分，B组(30.8±6.2)分。脊柱活动功能：A组改善15例，加重或无变化6例；B组改善25例，加重或无变化3例。神经功能：A组改善15例，加重或无变化6例；B组改善26例，加重或无变化2例。在改善腰痛、脊柱运动功能和神经功能方面，B组优于A组(P<0.05).在腿痛改善方面，两组无统计学差异(P>0.05).
结论：与传统后路减压、后外侧植骨融合治疗退变性腰椎滑脱症比较，加用椎弓根螺钉内固定能改善患者的腰痛症状和临床功能；减压作为退变性腰椎滑脱症手术治疗的基本原则，在改善患者腿痛方面起主要作用。 |
| 【关键词】退变性疾病 脊椎滑脱 脊柱融合术 |
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| Treatment of degenerative lumbar spondylolisthesis through posterolateral fusion and fixation with pedicle screws |
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ABSTRACT
Objective: To explore internal fixation whether can improve the clinical outcomes of decompression and posterolateral fusion in patients with degenerative lumbar spondylolisthesis.
Methods: From December 1998 to December 2005,49 patients who had degenerative lumbar spondylolisthesis underwent decompression and posterolateral fusion without(group A,21 cases) or with(group B,28 cases) internal fixation(CD HORIZON M8 system). There were 12 males and 37 females with a mean age of 58.5 years(range,from 49 to 68 years). Among them,32 cases were gradeⅠand 17 were grade Ⅱ according to Meyerding grade system. All patients were followed up with an average of 58 months(range from 12 to 90 months). The pain of low back and leg(VAS scoring),spinal active function and neurologic function were evaluated according the assessment system of Yuan.
Results: The VAS score of low back in group A and B were respectively 41.9±7.5 and 32.8±6.2 at follow-up;and VAS score of leg in group A and B were respectively 33.9±7.3 and 30.8±6.2. Spinal active function of patients,15 cases obtained improvement,6 cases aggravation or no improvement in group A;25 cases obtained improvement,3 cases aggravation or no improvement in group B. Neurologic function of patients,15 cases obtained improvement,6 cases aggravation or no improvement in group A;26 cases obtained improvement,2 cases aggravation or no improvement in group B. The group B was better than group A in the aspect of low back pain,spine active function and neurologic function(P<0.05). There was no statistically significant difference in improvement of leg pain between two groups(P>0.05).
Conclusion: Using internal fixation in decompression and posterolateral fusion for degenerative lumbar spondylolisthesis can improve low back pain and clinical function. Decompression is necessary for the surgical treatment of degenerative spondylolisthesis,which is major effect on the improvement of leg pain. |
| KEY WORDS Degenerative diseases Spondylolysis Spinal fusion |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陈可新,杨启友,刘兴才,李宏九.后外侧植骨融合椎弓根螺钉内固定治疗退变性腰椎滑脱症[J].中国骨伤,2010,23(4):254~256 |
| 英文格式: | CHEN Ke-xin,YANG Qi-you,LIU Xing-cai,LI Hong-jiu.Treatment of degenerative lumbar spondylolisthesis through posterolateral fusion and fixation with pedicle screws[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(4):254~256 |
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