中国骨与关节杂志
中國骨與關節雜誌
중국골여관절잡지
Chinese Journal of Bone and Joint
2014年
1期
10-14
,共5页
脊椎滑脱%骨牵引复位法%脊柱融合术%腰椎
脊椎滑脫%骨牽引複位法%脊柱融閤術%腰椎
척추활탈%골견인복위법%척주융합술%요추
Spondylolysis%Skeletal tracting reposition%Spinal fusion%Lumbar vertebrae
目的：回顾性总结分析腰椎椎间撑开复位、椎间融合内固定术治疗成人峡部裂型腰椎滑脱症。方法回顾总结2006年10月至2011年11月，收治的采用腰椎椎间隙撑开复位、椎间融合内固定术治疗的78例成人峡部裂型腰椎滑脱症患者的临床资料。男42例，女36例，年龄41～69岁，平均为52.4岁。病程3个月至7年，平均38个月。病变节段：L3峡部裂3例，L4峡部裂28例，L5峡部裂47例。按Meyerding分度：I度滑脱25例，II度滑脱47例，III度滑脱6例，滑移程度为(39.3±10.9)%。术后应用Oswestry功能障碍指数(ODI)、VAS评分及影像学检查对临床疗效进行评价。结果手术平均时间118min，术中出血平均340 ml。随访24～83个月，平均41个月。VAS评分术前为6.7±1.5、末次随访为1.7±1.3；ODI指数术前为(60.7±9.8)%、末次随访为(24.1±4.9)%；以上指标末次随访与术前比较差异均有统计学意义(P＜0.05)。滑移程度末次随访为(9.8±4.1)%，滑脱复位率为75.1%，2年融合率为97.4%。结论应用椎间隙撑开复位、椎间融合内固定治疗成人峡部裂型腰椎滑脱症，疗效确实，操作简单、安全，并发症少。
目的：迴顧性總結分析腰椎椎間撐開複位、椎間融閤內固定術治療成人峽部裂型腰椎滑脫癥。方法迴顧總結2006年10月至2011年11月，收治的採用腰椎椎間隙撐開複位、椎間融閤內固定術治療的78例成人峽部裂型腰椎滑脫癥患者的臨床資料。男42例，女36例，年齡41～69歲，平均為52.4歲。病程3箇月至7年，平均38箇月。病變節段：L3峽部裂3例，L4峽部裂28例，L5峽部裂47例。按Meyerding分度：I度滑脫25例，II度滑脫47例，III度滑脫6例，滑移程度為(39.3±10.9)%。術後應用Oswestry功能障礙指數(ODI)、VAS評分及影像學檢查對臨床療效進行評價。結果手術平均時間118min，術中齣血平均340 ml。隨訪24～83箇月，平均41箇月。VAS評分術前為6.7±1.5、末次隨訪為1.7±1.3；ODI指數術前為(60.7±9.8)%、末次隨訪為(24.1±4.9)%；以上指標末次隨訪與術前比較差異均有統計學意義(P＜0.05)。滑移程度末次隨訪為(9.8±4.1)%，滑脫複位率為75.1%，2年融閤率為97.4%。結論應用椎間隙撐開複位、椎間融閤內固定治療成人峽部裂型腰椎滑脫癥，療效確實，操作簡單、安全，併髮癥少。
목적：회고성총결분석요추추간탱개복위、추간융합내고정술치료성인협부렬형요추활탈증。방법회고총결2006년10월지2011년11월，수치적채용요추추간극탱개복위、추간융합내고정술치료적78례성인협부렬형요추활탈증환자적림상자료。남42례，녀36례，년령41～69세，평균위52.4세。병정3개월지7년，평균38개월。병변절단：L3협부렬3례，L4협부렬28례，L5협부렬47례。안Meyerding분도：I도활탈25례，II도활탈47례，III도활탈6례，활이정도위(39.3±10.9)%。술후응용Oswestry공능장애지수(ODI)、VAS평분급영상학검사대림상료효진행평개。결과수술평균시간118min，술중출혈평균340 ml。수방24～83개월，평균41개월。VAS평분술전위6.7±1.5、말차수방위1.7±1.3；ODI지수술전위(60.7±9.8)%、말차수방위(24.1±4.9)%；이상지표말차수방여술전비교차이균유통계학의의(P＜0.05)。활이정도말차수방위(9.8±4.1)%，활탈복위솔위75.1%，2년융합솔위97.4%。결론응용추간극탱개복위、추간융합내고정치료성인협부렬형요추활탈증，료효학실，조작간단、안전，병발증소。
Objective To retrospectively explore the clinical outcomes of intervertebral space distraction reduction and posterior lumbar interbody fusion with transpedicular screw/rod ifxation in the treatment of adult isthmic spondylolisthesis.Methods From October 2006 to November 2011, 78 patients with adult isthmic spondylolisthesis underwent the treatment of intervertebral space distraction reduction and posterior lumbar interbody fusion with transpedicular screw/rod ifxation, and their clinical data were retrospectively analyzed. There were 42 males and 36 females, whose average age was 52.4 years old ( range; 41-69 years ). The average course time was 38 months ( range;3-84 months ). The levels of lumbar spondylolisthesis was L3 in 3 cases, L4 in 28 cases and L5 in 47 cases. According to the Meyerding classiifcation, 25 cases were classiifed as degree I, 47 cases as degree II, and 6 cases as degree III. The average slippage degree was ( 39.3±10.9 ) %. The Visual Analogue Scale ( VAS ) and Oswestry Disability Index ( ODI ) were used to assess the clinical outcomes, and the imaging examination was also performed.Results The average surgical time was 118 minutes, and the average intraoperative blood loss was 340ml. All patients were followed up for an average period of 41 months ( range; 24-83 months ). The VAS scores were 6.7±1.5 points and 1.7±1.3 points preoperatively and in the latest follow-up respectively, and the differences were statistically signiifcant (P<0.05 ). The ODI scores were ( 60.7±9.8 ) % and ( 24.1±4.9 ) % preoperatively and in the latest follow-up respectively, and the differences were statistically signiifcant (P<0.05 ). The slippage degree was ( 9.8±4.1 ) % in the latest follow-up, with the reduction rate of 75.1% and the fusion rate of 97.4% at the 2nd year after the operation.Conclusions Intervertebral space distraction reduction and posterior lumbar interbody fusion with transpedicular screw/rod ifxation are safe in the treatment of adult isthmic spondylolisthesis, with the advantages of excellent clinical results, easy manipulation and fewer complications.
