经后路椎间植骨治疗下腰椎滑脱.doc

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1、经后路椎间植骨治疗下腰椎滑脱【摘要】目的观察经后路椎体间和椎板、横突间植骨融合术治疗腰椎滑脱，对比两种不同植骨融合的近远期效果。方法腰椎滑脱有手术指征患者，据CT判断椎管内马尾及神经根受压情况及平卧位后有无神经症状分为两组，A组14例，CT示椎管内硬脊膜囊及神经根受压明显及平卧位后神经症状部分消失，采用经后路椎管开窗减压及椎体间植骨融合术；B组20例，CT示椎管内硬脊膜囊及神经根受压不明显及平卧位后神经症状基本消失，采用椎板间或横突间植骨，以上患者均结合椎弓根内固定系统固定。结果随访时间1～2年，4～6个月椎体融合，无椎弓根螺钉松动、断裂，无椎体

2、间植骨脱落至椎管内，腰、下肢疼痛明显缓解及下肢肌力、感觉均有恢复，4～6个月后均能恢复日常生活及极轻体力工作。取得较满意疗效。结论椎体间和椎板、横突间植骨融合率和融合时间及术中平均输血量无明显差异，功能恢复无显著差异，A组植骨所需量少于B组。【关键词】椎体间植骨；腰椎滑脱；内固定UsingPosteriorInterverbralGraftBoneFusiontoTreatLowerSpondylolisthesisZUOHua，HUANGYonghui，SHENTiecheng(TheOrthopaedicDepartmentoftheAf

3、filiatedHospitalofJiangsuUniversity，Zhenjiang212001，China)Abstrac：ObjectiveToobservethetreatmenteffectsofthesurgeryforlumbarspondylolisthesisbyposteriorintervertebral(anteriorcolumn)(PLIFsurgery)，intervertebralplates，intertransverseprocessgraftbonefusion.Comparetheeffectsbetw

4、eenthetwokindsofgraftfusionintheshorttermandlongterm.MethodsWedividethelumbarspondylolisthypatientswhohavethesurgicalindicationsinto2groupsaccordingtotheresultsofthecomputerizedtomography.GroupA：caudaeguinanervalsymptomsdisappearpartlyatprostration.Theyaretreatedbyposteriorsp

5、inalcanaldecompressionbyfenestrationandintervertebralgraftbonefusion(PLIFsurgery).GroupB：In20cases，weseethatduramatersandnerverootsareslightlycompressedandthenervalsymptomsdisappearsnearlyatprostration.Theyaretreatedbyintervertebralplates，intertransverseprocessgraftbonefusion

6、s.Thoseabove2groupsarealsotreatedtogetherwithinternalfixationsystemofspinalpedicles.ResultsFollowupstudyofthepatientsrangefrom1to2years.Thevertebrafusesfrom4to6monthswithoutlooseningorcollapsingscrews，andnobonefragmentsfallintovertebralcanal.Thepainofthelumbarpartandlowerlim

7、brelievessignificantlywhilemuscleforceandsenserecovers.Patientscan4adapttodailylifeandslightphysicallabor.Thecurativeeffectissatisfactory.ConclusionThereisnosignificantdifferencebetweenthetwogroupsofthemountofbloodtransfusion、timeandfunctionrecoveryofthesurgeryofposteriorinte

8、rvertebral，(anteriorcolumn)(PLIFsurgery)，intervertebralplatesandinte