目的 探讨腰椎滑脱症的手术方法和疗效.方法 回顾分析2002 -02-2009-02收治的96例腰椎滑脱症患者,男44例,女52例,年龄36～65岁,平均50.5岁.其中,椎弓根峡部裂性滑脱43例,退变性腰椎滑脱49例,医源性滑脱4例.根据Meyerding方法确定滑脱程度:Ⅰ度滑脱71例,Ⅱ度21例,Ⅲ度4例.所有患者均采用后路减压、复位、短节段固定、经后外侧椎体间打压植骨、单枚融合器融合等方法施行手术治疗.通过JOA评分、滑脱复位率、融合率及并发症对疗效进行评估.结果 随访平均为54.6个月(15-98个月),获得完整随访资料86例.术后6个月JOA评分(24.37±2.46)分,与术前(11.52±2.97)分相比,差异显著(P＜0.05).术后疗效:优30例、良48例、可8例,优良率为90.7％( 78/86).滑脱复位率达87.23％；融合率达100％;未发生固定器械断裂、融合器移位等并发症.结论 后路减压、复位、短节段固定及后外侧椎间融合是治疗腰椎滑脱的良好术式.%Objective To observe operative methods and therapeutic effects of lumbar spondylolisthesis. Methods From February 2002 to February 2009,% cases of spondylolisthesis were treated with decompression, reduction, short-segment internal fixation and posterolateral interbody fusion. There were 44 males and 52 females with a mean age of 50.5 years (range from 36 to 65). Among them,43 cases were spondylolysis,49 cases were degenerative,and 4 cases were iatrogenic. According to Meyerding grade system,71 cases were grade 1,21 cases were grade Ⅱ,and 4 cases were grade Ⅲ. JOA scoring,reduction rate,fusion rate,complication were evaluated. Results 86 cases were followed up 15-98 months (mean 54.6 months). The JOA scoring were 11.52±2.97 points pre-operation and 24.37 ±2.46 points 6 months post-operation (P<0.05). Excellent or good rate were 90.7%. reduction rate were 87.23%, fusion rale were 100%. All cases achieved bony fusion without loose of internal fixation or subsidence of cage. Conclusion Complete posterior decompression , reduction, short-segment internal fixation and posterolateral interbody fusion is an effective surgical method for lumbar spondylolisthesis.
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