[1]吴群生.后路减压椎弓根钉棒系统内固定联合椎间融合器植骨融合治疗腰椎滑脱症[J].中医正骨,2016,28(11):30-33.
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后路减压椎弓根钉棒系统内固定联合椎间融合器植骨融合治疗 腰椎滑脱症()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期数:
2016年11期
页码:
30-33
栏目:
临床报道
出版日期:
2016-11-20

文章信息/Info

作者:
吴群生
河南省登封市人民医院,河南 登封 452470
关键词:
脊椎滑脱 腰椎 减压术外科 脊柱融合术 骨移植 内固定器
摘要:
目的:观察后路减压椎弓根钉棒系统内固定联合椎间融合器植骨融合治疗腰椎滑脱症的临床疗效及安全性。方法:2010年1月至2015年6月,采用后路减压椎弓根钉棒系统内固定联合椎间融合器植骨融合治疗腰椎滑脱症患者44例,男26例、女18例。年龄22~68岁,中位数47岁。退变性滑脱25例,峡部裂性滑脱19例。滑脱节段位于L3~43例、L4~518例、L5S123例。滑脱程度按照Meyerding分级标准,Ⅰ度15例、Ⅱ度22例、Ⅲ度7例。合并腰椎侧隐窝狭窄16例、腰椎间盘突出11例。病程2~10年,中位数4.6年。随访观察滑脱腰椎复位、腰背部疼痛、下肢放射性疼痛、腰椎功能恢复、无疼痛步行距离、手术综合疗效及并发症发生情况。结果:所有患者均获随访,随访时间12~24个月,中位数16个月。术后12个月X线检查显示,15例Ⅰ度滑脱完全复位、22例Ⅱ度滑脱19例完全复位、7例Ⅲ度滑脱5例完全复位。术后3、6、12个月,腰背部疼痛视觉模拟量表评分分别由术前(6.7±2.8)分降至(3.8±1.5)分、(2.8±1.3)分、(2.1±0.6)分,下肢放射性疼痛视觉模拟量表评分分别由术前(6.9±3.2)分降至(2.2±1.4)分、(1.6±1.2)分、(1.3±0.5)分,Oswestry功能障碍指数分别由术前(62±15)%降至(21±8)%、(18±7)%、(14±5)%,无疼痛步行距离分别由术前(200±51)m增加至(2000±106)m、(2000±168)m、(2000±566)m。均未出现内固定物松动、脱出、断裂及椎体再滑脱等并发症。术后12个月,参照侯树勋等制定的腰椎滑脱手术疗效标准评定综合疗效,优23例、良16例、可4例、差1例。结论:后路减压椎弓根钉棒系统内固定联合椎间融合器植骨融合治疗腰椎滑脱症,能够有效复位滑脱的椎体、减轻腰背部疼痛及下肢放射性疼痛、改善腰椎功能、增加无疼痛步行距离,具有疗效好、安全性高的优点,值得临床推广应用。

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更新日期/Last Update: 2016-11-30