椎弓根内固定联合椎体间植骨融合术治疗退行性腰椎滑脱症的临床探讨

目的:探讨椎弓根内固定联合椎体间植骨融合术治疗退行性腰椎滑脱症的临床效果。方法:回顾性分析我院2012年3月至2014年3月收治的30例采用椎弓根内固定联合椎体间植骨融合术治疗的退行性腰椎滑脱症患者临床资料,观察患者对手术效果的满意度,并对症状进行JOA评分。比较患者术前术后的腰椎X线的影像学变化,观察术后临近节段的退变发生率与影像的融合率。结果:术后随访1-3年发现患者JOA评分的平均改善率为(73.81±16.12)%,术后滑脱率与椎间高度均有明显改善,与术前比较差异具有统计学意义(P0.05)。术后影像学显示植骨融合A级15例,B级12例,C级3例,融合优良率为90%。结论:椎弓根内固定联合椎体间植骨融合术对退行性腰椎滑脱症具有显著的临床效果,不仅可以缓解疼痛,改善功能评分,而且使患者影像学变化恢复正常生理形态,是理想的手术方法之一。

Clinical Effects of Pedicle Screw Fixation and Interbody Fusion on Degenerative Lumbar Spondylolisthesis

Objective:To explore the clinical effects of pedicle screw fixation and interbody bone graft fusion on the treatment of degenerative lumbar spondylolisthesis (DLS).Methods:A retrospective study was conducted on the clinical data of 30 patients with DLS who were taken the pedicle screw fixation and interbody bone graft fusion surgery in our hospital from March 2012 to March 2014. Patients'' satisfactory rate of surgical effect was observed and symptoms were assessed by JOA scores. lumbar X-ray imaging changes were compared before and after the surgery. The incidence of degeneration and image fusion of postoperative adjacent segments were observed.Results:Followed up for 1 to 3 years found that patients with postoperative JOA score average period was (73.81+16.12) %. The post-operative slippage rate and intervertebral height were also significantly improved compared with those before the operation (P<0.05). The post-operative imaging indicated that 15 cases'' bone graft infusion were at level A, 12 cases at level B and 3 cases at level C, and the excellent rate of bone graft fusion was 90% .Conclusion:Pedicle screw fixation and interbody bone graft fusion implementation could improve the clinical symptoms and functional status of DLS patients, and restore radiographic changes to normal physiological form, which was an ideal operation method.