椎体间植骨融合术治疗腰椎椎体滑脱

目的探讨腰椎滑脱在RF器械复位固定的基础上行椎体间足量植骨融合术后的效果。方法对76例腰椎滑脱患者采用后路切口RF器械复位内固定,从一侧椎板开窗或半椎板切除进入椎管腔。切除大部分椎间盘组织,将15～20g自体髂骨块和术中所取的椎板骨植入椎间隙内,并冲击嵌紧。结果无切口感染及神经根损伤发现,切口脂肪液化2例,经2～3周换药愈合;脑脊液漏3例,3～5d夹管脑脊液漏停止。随访1～7年,近期椎体钉松动复位不良3例,74例椎体间植骨在6～12个月均骨性融合,融合率97.4%,根据侯树勋等的疗效评定标准：优63例,良10例,可3例。结论该手术具有损伤小,出血少,在RF器械复位固定的基础上,植骨量大,成骨迅速,骨性融合满意,并发症少。

Clinical study of lumbar spondylolisthesis treated with interbody fusion

Objective To evaluate the clinical outcomes of posterior lumbar interbody fusion using enough amounts of bone graft and RF internal fixation. Methods Posterior RF screw fixation combined with impacted interbody bone graft of 15- 20 g ilium and debris produced in the operation following diskectomy through interlaminar fenestration was used for 76 cases with lumbar spondylolisthesis. Results There was no would infection and nerve injury. 2 got would fat liquefaction and healed after 2 - 3 weeks dress changing. 3 got leakage of cerebrospinal fluid and healed in 3 5 days. All cases were followed up for 1 - 7 years. 3 got suboptimal reduction and screw loosening. 74 cases got interbody bony fusion in 6 - 12 months, and the fusion rate was 97.4%. According to evaluation standard of Hou Shuxun ：64 cases achieved excellent outcomes, 10 good, and 3 fair. Conclusions This kind of technique is a simple, safe,effective and mini-invasive therapeutic method.