Objective To evaluate the treatment of lumbar segmental instability PLIF adaptive method. Methods From December 2002 to October 2010 in our hospital, applied PLIF in the treatment of patients with lumbar segmental instability. In these cases has complete data 30 patients, (19 males and 11 females),aged 24 to 69 years,average 45.8 years old. Instability segments: L4-4 6 cases;L4_5 11 cases,L5-S1 13 cases. Three kinds of inter-body fusion included: simple inter-body, bilateral inter-body fusion and unilateral oblique cage. Patients in both supporting the use of pedicle screw fixation system,the latter two kinds of methods in place implants at the same time, were supplemented by inter-body analogous bone graft particles. According to the Nakai classification of clinical recovery,efficacy evaluation was in accordance with VAS (visual analogue scale). Results The patients were followed up 3 months to 6 years and 9 months,an average of 3 years and 7 months. After 18 months according to Nakai standards assessment: excellent in 19 cases, good in 9 cases,2 cases. Excellent rate were 93.3%. Patients with low back pain,leg pain symptoms were significantly alleviated, the vast majority of patients resumed normal work and life of the original. Conclusion PLIF surgical treatment of lumbar segmental instability is a more reliable method,so long as the indications for surgery can achieve satisfactory results.%目的 探讨应用PLIF治疗腰椎节段性不稳定的适应性.方法 2002-12-2010-10我院采用PLIF技术治疗腰椎节段性不稳定患者30例,男19例,女11例,年龄24～69岁,平均45.8岁.失稳节段:L3-6例,L4-5 11例,L5-S1 13例.3种椎间融合术包括:单纯椎体间植骨、双侧椎体间融合器、单侧斜行椎间融合器,术中均采用椎弓根固定系统辅助,后2种方法中在安放内置物的同时,均辅以椎间自体骨粒植骨.临床恢复情况按Nakai分级；疗效评定按照目测视觉类比评分法(visual analogue scale VAS).结果 随访3个月～6年9个月,平均3年7个月.术后18个月时按Nakai标准评定:优19例,良9例,可2例；优良率93.3％.患者的腰痛、下肢疼痛症状均有明显缓解,绝大多数患者恢复正常的工作和生活.结论 PLIF手术是治疗腰椎节段性不稳定比较可靠的方法,只要把握手术适应证,可以取得满意的结果.
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