后路360°融合术治疗腰椎滑脱症和不稳症的远期疗效.doc

后路３６０°融合术治疗腰椎滑脱症和不稳症的远期疗效 　　作者：陈柏龄,刘少喻,谢登辉,李佛保,梁春祥　　作者单位：中山大学附属第一医院骨科， 广东 广州 510080 　　【摘要】总结后路360°融合术治疗腰椎滑脱症和不稳症的远期疗效，并对该术式的优缺点进行探讨。【方法】 2001年开始使用后路椎弓根钉系统辅助360°融合术治疗腰椎滑脱症和不稳症共228例，选择获得2年以上随访、仅行单节段融合术的手术患者102例进行分析，其中腰椎滑脱症75例，腰椎退变性不稳症27例;应用X线评价植骨融合情况，视觉疼痛评分(VAS)、Oswestry功能障碍指数(ODI)问卷表、侯树勋标准评价腰腿痛程度及社会和生活功能情况。【结果】 随访24 ～ 84个月，平均43个月，102例中99例获骨性融合，骨融合率97.1%。下腰痛VAS术前为6.82 ± 1.33，术后为3.11 ± 1.05;腿痛VAS术前为8.25 ± 1.84，术后为4.32 ± 1.08。ODI术前为(68.6 ± 14.7)%，术后为(13.7 ± 1.6)%。侯树勋标准：优40例，良46例，可13例，差3例，优良率84.3%。 【结论】 后路360°融合术治疗腰椎滑脱症和不稳症的远期疗效满意，是一种可获得高融合率和良好临床疗效的积极手术方式。 　　【关键词】 腰椎; 后路; 脊柱融合术 　　Long-term Result of Posterior 360 Degree Fusion for Spondylolisthesisand Instability of Lumbar Spine　CHEN Bai-ling， LIU Shao-yu， XIE Deng-hui， LI Fo-bao， LIANG Chun-xiang， YU Bin-sheng　Department of Orthopedic， The First Affiliated Hospital of Sun Yat-sen University， Guangzhou 51000， China　Abstract： 【Objective】 To summarize the long-term result of posterior 360 degree fusion for the spondylolisthesis and instability of lumbar spine， and discuss the advantages and disadvantages of this operation. 【Method】 We came to use the posterior instrumented 360 degree fusion technique to treat the spondylolisthesis and instability of lumbar spine from 2001， and completed 228 cases. We selected 102 patients who were treated with only one segment fusion and followed up for at least 2 years， of them 75 cases suffered lumbar spondylolisthesis， 27 cases suffered degenerative lumbar instability. X-ray was used to evaluate the fusion condition of the bone graft ，and VAS， ODI questionnaire and Hou Shuxun Criterion were applied to assess the pain of back and leg ，and the conventional functions. 【Result】 All the selected patients were followed up for 24 to 84 months， averaged 43 months， 99 patients get bone fusion， accounted for 97.1%. The VAS of low back pain was 6.82 ± 1.33 before operation， while 3.11 ± 1.05 after operation. And the VAS of Leg pain was 8.25 ± 1.84 before operation ，while 4.32 ± 1.08