| 椎弓根螺钉内固定加椎体间融合器治疗腰椎滑脱症 |
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投稿时间：2003-05-16
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| 期刊信息：《中国骨伤》2004年，第17卷，第3期，第142-144页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目: |
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中文摘要:
目的:探讨后路椎弓根螺钉内固定加椎体间Cage融合术治疗腰椎滑脱症的疗效。
方法:手术治疗62例腰椎滑脱患者,其中行椎弓根螺钉内固定加Cage(21例)或植骨(3例)椎体间融合共24例:峡部裂型16例,退变性8例;腰4椎体滑脱13例,腰5椎体滑脱11例。按Meyerding分度:Ⅰ度滑脱18例,Ⅱ度滑脱6例。2例先作后路椎弓切除减压椎弓根螺钉复位内固定,再作前路Cage植入,一期完成手术;其余22例均作后路切口行椎弓切除或椎板切除神经减压,椎弓根螺钉复位内固定,后路椎体间融合,其中19例加用单枚Cage后外侧斜向植入行椎体间融合,另3例行椎体间植骨融合,而使用Cage病例中有6例在其前方加用骨碎块植骨。
结果:24例均获得3～48个月的随访,平均随访时间为18个月。根据Asher的疗效观察项目:优12例、良10例、可1例、差1例,优良率达917%。
结论:腰椎滑脱的治疗减压后的融合是关键;为了达到融合的目的,复位内固定是必要的;减压后椎弓根螺钉内固定加后路腰椎椎体间融合是一个值得推荐的治疗腰椎滑脱的手术方法;而后外侧斜向放置单个Cage是一种安全有效的后路椎体间融合的方法。 |
| 【关键词】椎间盘移位 骨移植 骨折固定术,内 腰椎 |
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| Treatment of lumbar spondylolisthesis with pedicle screw fixation and interbody Cage fusion |
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ABSTRACT
Objective:To investigate the therapeutic effectiveness of lumbar spondylolisthesis treated with pedicle screw fixation and interbody Cage fusion.
Methods:From 1998 to 2002,24 consecutive abult patients(age 37 to 67 years,with an average of 48.5 years)underwent surgical treatment with pedicle screw fixation and posterior lumbar interbody fusion with Cage(21 cases) or bone graft(3 cases) after decompression.There were 18 cases of I degree spondylolisthesis and 6 cases of Ⅱ degree spondylolisthesis.The clinical results and complications were evaluated and a radiographic assessment was performed.
Results:24 patients were followed up for an average of 18 months(range 3 to 48 months) after operation. According to the criteria of Asher,the therapeutic effectiveness was excellent in 12 cases,good in 10.cases,fair in 1 case,and poor in l case.The satisfactory rate was 91.7%.
Conclusion:Reduction of the spondylolisthesis and internal fixation is necessary in order to achieve a solid fusion.The addition of posterior lumbar interbody fusion after decompression to pedicle screw fixation is a recommend procedure for the treatment of lumbar spondylolisthesis.Posterolateral inclining placement of a single cylindrical threaded Cage is a safety and effective method of posterior lumbar interbody fusion. |
| KEY WORDS Intervertebral disk displacement Bone transplantation Fracture fixation,internal Lumbar vertebrae |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 吴琼华,陈正形,陈维善,陈其昕.椎弓根螺钉内固定加椎体间融合器治疗腰椎滑脱症[J].中国骨伤,2004,17(3):142~144 |
| 英文格式: | WU Qiong hua,CHEN Zheng xing,CHEN Wei shan,CHEN Qi xin.Treatment of lumbar spondylolisthesis with pedicle screw fixation and interbody Cage fusion[J].zhongguo gu shang / China J Orthop Trauma ,2004,17(3):142~144 |
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