不同术式治疗退变性腰椎滑脱伴椎管狭窄的疗效对比分析

摘要

目的：探讨比较不同术式治疗退变性腰椎滑脱伴椎管狭窄的治疗效果。方法对40例退变性腰椎滑脱伴椎管狭窄的患者，根据手术方式分为：A组行椎弓根螺钉复位内固定后椎间融合器(cage)融合，B组行椎弓根螺钉复位内固定结合椎间单纯植骨融合。对手术前后两组患者JOA评分,腰腿痛VAS评分,滑脱椎体融合率及相对椎间隙高度等进行随访，并统计分析。结果随访18～34个月，两组间术后滑脱椎体融合率及相对椎间隙高度均差异有统计学意义(P<0.05)；JOA评分和VAS评分差异无统计学意义(P>0.05)。结论两种术式一定程度上都能缓解症状，临床疗效相当，椎管狭窄患者行椎间融合器融合术比椎间单纯植骨术具有更优的远期疗效。%Objective To compare the treatment effect of different surgical treatment for patients with degenerative lumbar spondylolisthesis and spinal canal stenosis.Methods According to the surgical approach,40 patients were divided into two groups, Group A was treated with posterior lumbar interbody cage fusion and internal fixation with pedicle screw system, and group B was treated with pedicle screw fixation combined with interbody bone graft fusion.Results The patients were followed up for 18 to 34 months; there were statistically significant differences between the two groups in postoperative spondylolisthesis fusion rate and the corresponding intervertebral height(P<0.05); no statistically significant differences between the groups in JOA score and VAS score (P>0.05). Conclusion Both surgical methods can relieve the symptoms to a certain extent and have the same efficacy, but interbody cage fusion surgery has better long-term outcome than interbody bone graft surgery does.