CAJ | 학술논문

目的探讨腰椎退行性多节段滑脱的手术治疗方法.方法 2005年3月至2008年9 月,采用后路彻底减压、复位、椎弓根内螺钉固定360°融合治疗多节段腰椎滑脱患者25例.其中男性7例,女性18例;年龄38-75岁,平均56.6岁.滑脱均为退行性变化引起,类型有:前滑脱12例,后滑脱2例,混合滑脱11例.患者均行腰椎后路减压融合手术,术后随访6个月-4年,根据 Lenke 标准评价脊柱植骨融合情况,根据 Henderson 标准评价临床疗效.结果术后25例患者均获得完全复位.植骨融合结果:Lenke A级23例,B级2例;临床疗效Henderson评价结果:优16例,良6例,可 3例.结论多节段腰椎退变滑脱发病机制和治疗方法与单节段腰椎滑脱不尽相同,后路彻底减压, 适度复位,后外侧植骨融合结合椎间融合能获得较好的临床效果.多节段滑脱复位时应根据滑脱的类型选择不同方法.
목적 탐토요추퇴행성다절단활탈적수술치료방법.방법 2005년3월지2008년9 월,채용후로철저감압、복위、추궁근내라정고정360°융합치료다절단요추활탈환자25례.기중남성7례,녀성18례;년령38-75세,평균56.6세.활탈균위퇴행성변화인기,류형유:전활탈12례,후활탈2례,혼합활탈11례.환자균행요추후로감압융합수술,술후수방6개월-4년,근거 Lenke 표준평개척주식골융합정황,근거 Henderson 표준평개림상료효.결과 술후25례환자균획득완전 복위.식골융합결과:Lenke A급23례,B급2례;림상료효Henderson평개결과:우16례,량6례,가 3례.결론 다절단요추퇴변활탈발병궤제화치료방법여단절단요추활탈불진상동,후로철저감압, 괄도복위,후외측식골융합결합추간융합능획득교호적림상효과.다절단활탈복위시응근거활탈적류형선택불동방법.
Objecttve To discuss the surgical treatment of multilevel lumbar degenerative spondylolisthesis.Methods From March 2005 to September 2008.25 cases of multilevel lumbar degenerative spondylolisthesis were treated with total laminectomy,reduction of spondylolisthesis and 360° circunferential fusion through interbody (PLIF),transverse process (PLF) and pediele screw fixation.All cases were followed up for 0.5-4 years.The Lenke grading system Wag used to assess the spinal fusion and Henderson grading system was used to assess the clinical outcomes.Results Complete reduction of spondylolisthesis was achieved in all cases.The bone fusion was grade A in 23 cases.grade B in 2 cases. The clinical outcome Was excellent in 16 cases.good in 6 cases and poor in 3 cases.Conclusions The pathogenesis of lumbar degenerative multilevel spondylolisthesis is different from that of single-level spondylolisthesis.Complete decompression,reduction of spondylolisthesis sufficient fusion and reliable pediele screw fixation Can provide successful interbody fusion and satisfactory clinical results.It'S crucial to reduce multilevel spondylolisthesis by proper techniques based on different types of listhesis.