后路不同术式治疗腰椎退变性滑脱65例临床疗效比较

郭玉海  林定坤  陈博来

（广州中医药大学附属广东省中医院脊柱专科，广东，广州，510120）

摘　要　目的：比较几种不同后路手术方式治疗腰椎退变滑脱症的临床疗效。方法：65例患者根据是否可行内固定及融合方式分成A（单纯椎板减压+后外侧植骨）、B(椎弓根固定+后外侧植骨)、C(椎弓根固定+椎体间自体植骨)、D(椎弓根固定+椎体间融合+Cage)四组，采用ODI评分方法对患者术前术后的情况进行评估，VAS评分标准进行疼痛程度评估，SUK标准对患者手术前后的正侧位片及动力位片进行融合评估。结果：所有病例均获得1～2年随访，B、C、D三组在腰椎稳定性及临床疗效方面均优于A组，D组在椎间高度、生理曲度维持方面均优于A、B、C三组。结论：后路椎弓根螺钉内固定加椎体间Cage植骨融合是治疗腰椎退变滑脱的理想术式。

关键词  腰椎退变滑脱；后路椎间融合；椎弓根

A comparative study of different posterior lumbar surgery technique on degenerative spondylolisthesis

Guo Yuhai, , Lin Dingkun, Chen Bolai.

Department of Orthopaedics, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou Traditional Chinese Medicine University, Guangdong, Guangzhou, 510120, China

Abstract  Objective: To investigate different therapeutic effectiveness of spondylolisthesis treatment. Method: 65 patients were divided intoA、B、C、D four groups and their preoperative and post operative states were evaluated through ODI scoring system, while their preoperative and post operative pain degree assessed by VAS scoring system, and evaluation of lumbar fusion was conducted to their preoperative and postoperative anterior posterior, lateral and bending X ray films.Result:65 cases were followed up for 1～2 years. B、Cand D groups were superior to the A on lumbar stability and clinical curative effect, while D group was superior to the others on interbody height and spinal curvature Conclusion:Pedicle screw fixation+PLIF is a safe and effective method in the treatment of lumbar spondylolisthesis.

Keywords  Spondylolisthesis;  Posterior lumbar interbody fusion(PLIF);  Pedicle screw