经关节突入路椎间融合椎弓根固定治疗峡部裂性腰椎滑脱

目的 评价经关节突入路手术治疗峡部裂性腰椎滑脱的应用价值。方法 2000年 9月 ~2003年 5月我院手术治疗峡部裂性腰椎滑脱患者 83例,随访患者 81例,年龄(55. 25±19. 21)岁,随访时间 (1. 68±0. 93)年。按照不同的手术入路方法分为两组,Ⅰ组经关节突入路,椎间融合椎弓根固定;Ⅱ组经椎板切除入路,椎间融合椎弓根固定。按各组术中的临床出血量、手术时间、术前和术后JOA评分等数据经SPSS11. 5统计软件处理数据。结果　术后采用Stauffer Coventry下腰椎术后疗效评定标准:临床优良率分别为 87%与 75%;术后神经功能改善率分别为 87. 81%与62. 88%。术后均无螺钉松动、断裂或者滑脱加重等并发症,有 3例假关节形成。结论　在峡部裂性腰椎滑脱的患者的手术治疗中,经关节突入路椎间融合椎弓根固定技术具有良好的临床效果。

Intervertebral fusion with pedicle screw fixation through articular process approach in the treatment of lumbar broken isthmus spondylolisthesis

Objective To evaluate the effect of intervertebral fusion with pedicle screw fixation through articular process approach on lumbar broken isthmus spondylolisthesis.Methods 81 cases aged 55.25±19.21 years old were taken a follow-up for 1.68±0.93 years from 83 cases, who were treated from September 2000 to May 2003.They were divided into two groups, according to the operation methods. The first group was treated with intervertebral fusion with pedicle screw fixation through articular process approach, while the second group was treated with posterolateral intervertebral fusion (PLIF). Interbody Cages were used in the two groups. The datas of the bleeding, operation time, preoperative and postoperative JOA Scores were done with by the statistic software of SPSS 11.5. Results According to the evaluation of postoperative curative effect in low lumbar spine by Stauffer-Coventry,the clinical excellent and good rates of the two groups were respectively 87% and 75%, and the recovery rates were 87.81% and 62.88%. There was no complication such as screw loosen, broken or slippage, except pseudoarticulation formation in 3 cases.Conclusion The technique of intervertebral fusion with pedicle screw fixation through articular process approach has a good clinical effect on lumbar broken isthmus spondylolisthesis in the operation.