CAJ | 학술논문

目的:对比观察后外侧融合、椎体间融合与环周融合结合椎弓根内固定治疗成人腰椎滑脱症的疗效.方法:回顾性分析2004-01/2008-05苏州大学附属第一医院收治的腰椎滑脱患者75例,男22例,女53例.年龄49～70岁,平均53.3岁;L4滑脱47例,L5滑脱28例;Ⅰ度滑脱5例,Ⅱ度滑脱24例,Ⅲ度37例,Ⅳ度滑脱g例.75例患者中后外侧融合结合椎弓根内固定治疗21例,椎体间融合结合椎弓根内固定治疗26例,环周融合结合椎弓根内固定治疗28例.对比分析3组患者内固定后随访时满意率与植骨融合率.结果:75例患者均获得随访,随访时间6个月～3年.后外侧融合组融合率57%,临床疗效满意率62%;椎体间融合组融合率85%,疗效满意率为89%;环周融合组融合率89%,临床疗效满意率93%;椎体回融合组与环周融合组融合率和疗效满意率相比,差异无显著性意义(P>0.05),椎体间融合组与环周融合组明显优于后外侧融合组(P<0.05).结论:椎体间融合与环周融合结合椎弓根钉内固定置入治疗成人腰椎滑脱症疗效相同,优于后外侧融合.
목적:대비관찰후외측융합、추체간융합여배주융합결합추궁근내고정치료성인요추활탈증적료효.방법:회고성분석2004-01/2008-05소주대학부속제일의원수치적요추활탈환자75례,남22례,녀53례.년령49～70세,평균53.3세;L4활탈47례,L5활탈28례;Ⅰ도활탈5례,Ⅱ도활탈24례,Ⅲ도37례,Ⅳ도활탈g례.75례환자중후외측융합결합추궁근내고정치료21례,추체간융합결합추궁근내고정치료26례,배주융합결합추궁근내고정치료28례.대비분석3조환자내고정후수방시만의솔여식골융합솔.결과:75례환자균획득수방,수방시간6개월～3년.후외측융합조융합솔57%,림상료효만의솔62%;추체간융합조융합솔85%,료효만의솔위89%;배주융합조융합솔89%,림상료효만의솔93%;추체회융합조여배주융합조융합솔화료효만의솔상비,차이무현저성의의(P>0.05),추체간융합조여배주융합조명현우우후외측융합조(P<0.05).결론:추체간융합여배주융합결합추궁근정내고정치입치료성인요추활탈증료효상동,우우후외측융합.
OBJECTIVE:To compare the therapeutic effect of surgical approach that should be used for posterior interbody fusion,posterolateral fusion with or without lumbar interbody fusion for adult spondylolisthesis.METHODS:From January 2004 to May 2008,75 patients with adult spondylolisthesis were retrospectively analyzed,comprising 22 males and 33 females,aged 53.3 years (ranging 49-70 years).There were 47 cases in L4,28 in L5;5 cases of degree Ⅰ,24 of degree Ⅱ,37 cases of degree Ⅲ,and 9 of degree Ⅳ.A total of 21 patients were treated with pedicle screw fixation and posterolateral lumbar fusion (group A),26 with pedicle screw fixation and posterior lumbar interbody fusion using cage (group B),and 28 with pedicle screw fixation and posterolateral lumbar fusion with posterior lumbar interbody fusion using cage.The satisfaction rate and fusion rate were compared among the three groups.RESULTS:All 75 patients were followed up for 6 months 3 years.The fusion rate of group A was 57%,and the satisfaction rate was 62%;the fusion rate of group B was 85%,and the satisfaction rate was 89%;the fusion rate of group C was 89%,and the satisfaction rate was 93%.There were no significant differences in the satisfaction rate and fusion rate between groups B and C (P>0.05),but the satisfaction rate and fusion rate of groups B and C were superior over group A (P<0.05).CONCLUSION:Posterior interbody fusion and posterolateral fusion with lumbar interbody fusion display similar treatment effects,which are better than posterolateral fusion.