【摘要】 [目的]探讨后路减压复位融合内固定术治疗退变性腰椎滑脱的远期疗效。[方法]2001年1月~2005年7月行后路减压、植骨融合、椎弓根螺钉复位内固定术,资料完整并获得末次随访的退变性腰椎滑脱患者62例,随访5~9年(平均6.4年)。融合方式有后外侧融合(PLF)、自体髂骨椎间融合(PLIF)、椎间Cage植入融合(PLIF+Cage)。评价JOA评分改善率、优良率、满意度、融合及临近节段退变情况等,对术前、术后及末次随访时滑脱率、椎间高度、椎间盘角、节段侧凸角等影像学指标进行比较和分析。[结果]JOA评分改善率(67.7±19.4)%,优良率85.5%,满意度87.1%,融合率95.2%,临近节段退变或原有退变加重26例(41.9%),各融合方式间均无显著性差异(P>0.05)。术后滑脱率、椎间高度、椎间盘角及节段侧凸角较术前均显著改善(P<0.05),末次随访时滑脱复位、椎间高度、椎间盘角有所丢失,椎间Cage植入融合丢失最少。[结论]后路减压、植骨融合、椎弓根螺钉复位内固定术治疗退变性腰椎滑脱远期疗效满意,椎间Cage植入融合的放射学表现更佳。更多还原

【Abstract】 [Objective]To investigate the long-term results of posterior fusion in the treatment of degenerative lumbar spondylolisthesis. [Methods]Sixty-two patients suffered from degenerative lumbar spondylolisthesis with complete information underwent posterior decompression,fusion,reduction and fixation with pedicle screw system between January 2001 and July 2005.Fusion methods included posterolateral lumbar fusion(PLF),posterior lumbar interbody fusion(PLIF) with autologous ilium and PLIF with Cage.They were followed up for 5 to 9 years(average,6.4 years).The JOA scores recovery rate,excellent and good results,satisfaction degree,fusion rate and adjacent segment degeneration were evaluated.The preoperative,postoperative and the last follow-up of slip rate,intervertebral height,disc angle and segmental scoliosis angle were compared and analyzed.[Results]The JOA scores recovery rate was 67.7±19.4%,the excellent and good results was 85.5%,the satisfaction degree was 87.1%,the fusion rate was 95.2%.Tweenty-six patients(41.9%) developed adjacent segment degeneration or increased degeneration.There were no significant differences between the three fusion methods(P>0.05).The slip rate,intervertebral height,disc angle and segmental scoliosis angle were improved significantly postoperatively than preoperatively(P<0.05).Spondylolisthesis reduction,intervertebral height and disc angle lost a little at the time of last follow-up,and PLIF with Cage had little loss.[Conclusion]Posterior decompression,fusion,reduction and fixation with pedicle screw system can achieve good long-term results in treatment of degenerative lumbar spondylolisthesis.PLIF with Cage can have a better radiographic improvement.更多还原