【摘要】 目的探讨腰椎后路椎间植骨融合术(PLIF)手术治疗退行性腰椎管狭窄症伴腰椎失稳的疗效。方法回顾分析2006年7月~2011年10月使用PLIF手术方式治疗的退行性腰椎管狭窄伴腰椎失稳患者75例,46例采用单节段减压植骨椎弓根螺钉系统内固定,29例采用多节段减压植骨椎弓根螺钉系统内固定。结果随访1~5年,平均1年8个月,根据JOA评分,优37例,良30例,中6例,差2例,优良率达89.33%,无断钉、松动或围手术期死亡。所有病例术后1年CT扫描可见骨性融合;椎间隙高度术后7d平均为(11.2±1.1)mm,末次随访为(11.0±1.1)mm。椎间高度术后7d与末次随访比较差异无统计学意义(P>0.05)。结论 PLIF治疗退行性腰椎管狭窄症伴腰椎失稳可提供彻底的减压效果和椎间稳定性,临床效果满意。更多还原

【Abstract】 Objective To discuss clinical efficacy of posterior lumbar interbody fusion(PLIF)surgery for the treatment of degenerative lumbar spinal stenosis and instability. Methods From July 2006 to October2011,75 patients with degenerative lumbar spinal stenosis and instability were treated by PLIF,46 of them received single-segment decompression interbody fusion with pedicle screw system internal fixation,29 of them received multi-segment decompression interbody fusion with pedicle screw system internal fixation. Results All patients were followed up for 12~60months,with the average time of 20 months.Clinical outcome was evaluated by using JOA,37 cases obtained excellent results,30 good,6fair and 2poor,the satisfactory rate was 89.33%,no nails break or loose,no peri-operative death.Solid bony fusion could be obtained by assessment using computed tomography(CT)scanning in all patients 1year after operation.The mean intervertebral height maintained(11.2±1.1)mm on day 7postoperatively and(11.0±1.1)mm at final follow-up.There were no statistical difference in comparison of postoperative intervertebral height between the seventh day and final follow-up(P >0.05). Conclusion There is good therapeutic effectiveness of PLIF for treating degenerative lumbar spinal stenosis and instability in decompression and keeping intervertebral stability.更多还原