CAJ | 학술논문

目的：探讨经后路椎间植骨融合联合 GSS（General Spine System ，GSS）脊柱内固定系统治疗腰椎滑脱症的临床疗效。方法：我科2011年7月－2014年7月，共收治腰椎滑脱48例。对48例经后路椎间植骨融合联合 GSS 脊柱内固定系统治疗的临床资料进行回顾性分析，并采用 JOA 评分标准、影像学指标对疗效进行综合评定。结果：本组患者平均手术时间（185．21±30．41）min ，出血量（560．24±35．32）ml 。术后随访时间6个月～3年（平均24个月），所有患者均获得骨性融合，均未出现血管神经损伤，钉棒松动、移位、断裂及复位丢失等并发症。按 JOA 评分系统，末次随访优45例，良2例，可1例，优良率达97．9％；其中Ⅰ°滑脱32例完全复位、4例部分复位，10例Ⅱ°滑脱中的8例完全复位、2例改善为Ⅰ°，Ⅲ°滑脱2例复位至小于Ⅰ°，术后患者完全复位率为83．3％。结论：采用后路椎间植骨融合联合 GSS 脊柱内固定系统治疗腰椎滑脱症，具有疗效满意、固定牢靠、融合率高等优点，是治疗腰椎滑脱症较为理想的术式之一。
목적：탐토경후로추간식골융합연합 GSS（General Spine System ，GSS）척주내고정계통치료요추활탈증적림상료효。방법：아과2011년7월－2014년7월，공수치요추활탈48례。대48례경후로추간식골융합연합 GSS 척주내고정계통치료적림상자료진행회고성분석，병채용 JOA 평분표준、영상학지표대료효진행종합평정。결과：본조환자평균수술시간（185．21±30．41）min ，출혈량（560．24±35．32）ml 。술후수방시간6개월～3년（평균24개월），소유환자균획득골성융합，균미출현혈관신경손상，정봉송동、이위、단렬급복위주실등병발증。안 JOA 평분계통，말차수방우45례，량2례，가1례，우량솔체97．9％；기중Ⅰ°활탈32례완전복위、4례부분복위，10례Ⅱ°활탈중적8례완전복위、2례개선위Ⅰ°，Ⅲ°활탈2례복위지소우Ⅰ°，술후환자완전복위솔위83．3％。결론：채용후로추간식골융합연합 GSS 척주내고정계통치료요추활탈증，구유료효만의、고정뢰고、융합솔고등우점，시치료요추활탈증교위이상적술식지일。
Objective :To investigate the clinical effect for lumbar spondylolisthesis by posterior General Spine system combined with lumbar interbody fusion .Methods :Clinical data of 48 patients of lumbar spondylolisthesis treated by pos‐terior General Spine system combined with lumbar interbody fusion from July 2010 to July 2014 were retrospectively analyzed .The JOA score and some radiological parameters were used to assess clinical outcome .Results :The average operation time and blood loss of the group were (185 .21 ± 30 .41)min and (560 .24 ± 35 .32)ml .After operations ,all the patients were followed up for 6 ~ 36 months(average 24 months) .The mean time of bony fusion was 6 months with a range of 3 ~ 12 months ,there are no complications such as nerve root injury ,vascular injury ,and all of the patient in‐ternal fixation didn’t loose ,break and loss of reduction .At the final follow‐up ,according to Japanese Orthopedic Asso‐ciation(JOA)score classification ,the results were excellent in 45 cases ,good in 2 cases ,fair in 1 case ,which excellent and good were presented in 97 .9% .While there were 40 patients in the complete reduction group ,achieving spondylo‐listhesis reduction rate of 83 .3% ;8 patients were in the partial reduction group ,achieving spondylolisthesis reduction rate of 16 .7% .Conclusion :Posterior General Spine system combined with lumbar interbody fusion provided satisfactory effect ,fixed sturdy and high fusion rate ,which is an ideal and effective treatment method for lumbar spondylolisthesis .