峡部裂性与退行性腰椎滑脱症手术选择及临床评价

目的：通过对120例腰椎滑脱症手术治疗患者的回顾性临床分析，探讨有关胺惟滑脱症的术式选择及治疗效果。方法：依据患者病情分别采取以下两种术式。A组，峡部裂性腰椎滑脱，行椎弓根钉固定复位后外侧椎板关节突间融合加峡部植骨融合术57例，Ⅰ度33例，Ⅱ度14例，Ⅲ度10例；B组，退行性腰椎滑脱，行开窗椎管减压、椎弓根钉固定复位后外侧椎板关节突间植骨融合术63例，Ⅰ度45例，Ⅱ度18例，均合并腰椎管狭窄，其中合并腰椎间盘突出症15例。结果：随访6～36个月，平均18个月。A组植骨融合率100％，术后滑脱复位率93％；B组植骨融合率100％，术后滑脱复位率90％。结论：后路复位椎弓根钉固定后外侧椎板关节突间峡部植骨融合术是治疗腰椎滑脱症的有效方法之一。

Clinical Evaluation of Different Surgical Procedures for Treating the Lumbar Isthmus Cleavage and De generative Lumbar Spondylolisthesis

Objective：The different types of surgical procedures were evaluated through analyzing the data of 120 cases with lumbar spondylolisthesis treated by surgical intervention. Methods：The patients were divided into group A and B according to the patients＇ conditions. Group A was consisted of 57 cases with lumbar spondylolisthesis owing to isthmus cleavage, among which 33 cases belonged to degree I, and 14 to degree Ⅱ and 10 to degree Ⅲ. They were treated with posterior pedicle screw fixation and bone graft fusion ; Group B was consisted of 63 cases with degenerative spondylolisthesis of degree Ⅰ （45 cases） and Ⅱ （ 18 cases） combined with spinal stenosis, among the later, 15 cases were associated with lumbar disc protrusion. These patients re- ceived the vertebral canal decompression by fenestration and the bone graft fusion after the posterior pedicle screw fixation. Results：During a period of follow up of 6 -36 months, an average of 18 months, the patients from group A and B gained completely fusion of bone graft, the ratios of slipped bone reduction were 93% and 90% respectively. Conclusions ：The posterior pedicle screw fixation and the isthmus bone graft fusion is one of modus operandi to treat lumbar spondylolisthesis.