腰椎弓根内固定联合椎间隙植骨融合治疗腰椎滑脱症的临床效果

摘要

目的 探讨腰椎弓根内固定联合椎间隙植骨融合治疗腰椎滑脱症的临床效果.方法 选择2012年7月至2015年8月解放军第八二医院确诊为腰椎滑脱症的患者100例,根据随机数字表法分为观察组和对照组,各50例.对照组采取单纯经腰椎弓根植骨融合内固定治疗,观察组采取腰椎弓根内固定联合椎间隙植骨融合治疗.术后随访6个月,比较2组患者的复位率、融合率、疼痛视觉模拟量表(VAS)评分、腰椎功能障碍指数(0DI)评分以及并发症发生情况.结果 治疗后,观察组复位率、融合率均明显高于对照组[100.0％(50/50)比94.0％(47/50)、82.0％ (41/50)比72.0％(36/50)],差异均有统计学意义(P＜0.05).治疗前,2组VAS评分和ODI评分比较,差异均无统计学意义(均P＞0.05).治疗后6个月,2组VAS评分和ODI评分均明显低于治疗前[观察组:(1.2±0.5)分比(7.2±1.3)分、(5.3±1.2)分比(33.4±4.8)分;对照组:(4.1±0.9)分比(7.4±1.3)分、(17.6±2.7)分比(32.9±4.7)分],且观察组明显低于对照组,差异均有统计学意义(均P ＜0.05).观察组并发症发生率明显低于对照组[10.0％ (5/50)比26.0％ (13/50)],差异有统计学意义(P＜0.05).结论 腰椎弓根内固定联合椎间隙植骨融合治疗腰椎滑脱症临床效果较好,且并发症较少.%Objective To explore the clinical effect of lumbar pedicle internal fixation combined with intervertebral bone graft fusion in treating lumbar spondylolisthesis.Methods Totally 100 patients with lumbar spondylolisthesis from July 2012 to August 2015 were randomly divided into observation group (50 cases) given lumbar pedicle internal fixation combined with intervertebral bone graft fusion and control group (50 cases) given single lumbar pedicle internal fixation.Six months after operation,the reduction rate,fusion rate,visual analogue scale (VAS) score and Oswestry disability index (ODI) were compared between groups,the complications were observed.Results The reduction rate and fusion rate in observation group were significantly higher than those in control group [100.0％ (50/50) vs 94.0％ (47/50),82.0％ (41/50) vs 72.0％ (36/50)] (P ＜ 0.05).Before treatment,VAS score and ODI score were not significantly different between groups (P ＞ 0.05);6 months after operation,the VAS score and ODI score were significantly decreased compared with those before operation in both observation group [(1.2 ± 0.5) scores vs (7.2 ± 1.3) scores,(5.3 ± 1.2) scores vs (33.4 ± 4.8) scores]and control group [(4.1 ± 0.9) scores vs (7.4 ± 1.3) scores,(17.6 ± 2.7) scores vs (32.9 ± 4.7) scores],and they were more lower in observation group (P ＜ 0.05).The incidence of complication in observation group was significantly lower than that in control group [10.0％ (5/50) vs 26.0％ (13/50)] (P ＜ 0.05).Conclusion Lumbar pedicle internal fixation combined with intervertebral bone graft fusion has good effect in treating lumbar spondylolisthesis,with less complications.