Objective:To compare the clinical effects of isthmic spondylolisthesis by a single cage or double cages inter-body fusion combined with pedicle screw fixation. Methods:The clinical data of 172 patients with isthmic spondylolisthesis underwent surgery from March 2000 to August 2008 were retrospectively analyzed. All cases underwent posterior pedicle screw fixation and interbody fusion,89 cases with single cage fusion and 83 cases with double cages fusion. In single cage group , there were 56 males and 33 females,aged from 18 to 63 years old with an average of (41.60±8.20) years;25 cases were in L4 segment and 64 cases were in L5;according to the Meyerding standard,32 cases wereⅠdegree,46 cases wereⅡdegree and 11 cases wereⅢdegree. In double cage group,there were 49 males and 34 females,aged from 20 to 65 years old with an aver-age of (43.30±6.39) years;21 cases were in L4 and 62 cases were in L5;according to the Meyerding standard,25 cases wereⅠdegrees,45 cases were Ⅱ degree,and 13 cases were Ⅲ degree. The operative time,intraoperative blood loss,postoperative drainage volum,bone fusion rate,intervertebral space height and the improvement of clinical symptoms were compared be-tween two groups. Results:All the operations were successful and all patients were followed up for 18 to 83 months with an av-erage of 4 years and 3 months. The operative time,intraoperative blood loss,postoperative drainage volume in single cage group were less than of double cage group (P<0.05). Two weeks after operation,the intervertebral space height was significantly in-creased in two groups (P<0.05),and there was no significant difference at the last follow up between two groups. At 16 months after operation,all bone grafts of patients got bony fusion by X rays. At the last follow up,there were no statistically significant difference in JOA,ODI and VAS score between two groups,no pedicle screw loosening and breaking were found. Conclusion:Single cage interbody fusion combined with pedicle screw fixation is as effective as with double cages interbody fusion in treat-ment of isthmic spondylolisthesis ,it has the advantages of short operative time and less blood loss.%目的:比较单枚cage或双枚cage椎间融合联合椎弓根螺钉固定治疗峡部裂性腰椎滑脱症的疗效.方法:对2000年3月至2008年8月手术治疗的172例峡部裂性腰椎滑脱症患者的临床资料进行回顾性分析,172例患者均采用后路椎弓根螺钉固定椎间融合术.其中使用单枚cage融合89例(单枚组),男56例,女33例;年龄18~63岁,平均(41.60±8.20)岁;L4滑脱25例,L5滑脱64例;MeyerdingⅠ度滑脱32例,Ⅱ度46例,Ⅲ度11例.双枚cage融合83例(双枚组),男49例,女34例;年龄20~65岁,平均(43.30±6.39)岁;L4滑脱21例,L5滑脱62例;MeyerdingⅠ度滑脱25例,Ⅱ度45例,Ⅲ度13例.比较两种手术方式的手术时间、术中出血量、术后引流量、植骨融合率、椎间隙高度以及临床症状改善情况.结果:所有患者顺利完成手术并获得随访,随访时间18~83个月,平均4年3个月.单枚组平均手术时间、术中出血量、术后引流量均少于双枚组(P<0.05).术后2周两组椎间隙高度均较术前明显增高,末次随访时两组差异无统计学意义.术后16个月,X线片示两组患者椎体间植骨均骨性融合.末次随访时两组患者JOA、ODI、VAS评分差异均无统计学意义,无椎弓根螺钉松动、断裂情况发生.结论:单枚cage椎间融合联合椎弓根螺钉固定治疗峡部裂性腰椎滑脱症与双枚cage椎间融合临床效果相同,且具有手术时间短、出血量少等优点,是一种安全有效的手术方式.
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