Objective We investigated the relationship of herniation and spondylolisthesis internal reactions,the operation method and curative effect by the mechanics principle. Methods We choose 68 patients with the waist dish outstanding combination of spondylolisthesis as the research object,and all these patients were randomly divided into surgical and non surgical group. The surgery group included 34 cases with surgical treatment according to the specific situation. Those who did not use reset the pelvic traction combined with massage treatment were con-sidered as observation group. The curative effect was observed. Results Scores of 34 patients with postoperative X - ray examination showed that all the osseous fusion vertebral body,the slippage vertebral surgery or basic completely reset,no incision infection,and other complica-tions,no looseness,breakage of internal fixation. Patients discharged rate from hospital scores was 97. 06% ,while the rate of not achieving fine rate was 67. 65% ,the difference is statistically significant( P < 0. 05). Postoperative follow - up rate in of surgery group was 94. 12% ,the surgical group was 52. 94% ,difference is very obvious statistical significance( P < 0. 01). Conclusion Lumbar disc merger and spondylolis-thesis had causal relationship. Surgical intervention to keep the spine of the instantaneous center of rotation in normal stress range to maintain the mechanical stability of spine in each direction. The long - term effect can have a good ideal.%目的：用力学原理探讨腰椎间盘突出与脊椎滑脱的内在关系和手术方式选择及疗效。方法选择68例腰椎间盘突出合并脊椎滑脱患者为研究对象，随机分为手术组和非手术组，手术组根据患者的具体情况进行手术治疗；非手术组采用骨盆牵引结合推拿复位进行治疗，观察治疗治疗效果。结果手术组34例患者术后行 X 线片检查，显示椎体全部为骨性融合，术前滑脱的椎体在术后完全或基本复位，无切口感染及其它并发症，无内固定物松动、断裂现象。患者出院时手术组优良率为97.06％，非手术组优良率为67.65％，手术组优良率高于非手术组，差异有明显的统计学意义（ P ＜0.05）；患者出院6个月后随访结果显示，手术组优良率94.12％，非手术组优良率52.94％，手术组优良率高于非手术组，差异具有非常明显的统计学意义（ P ＜0.01）。结论腰椎间盘突出和脊椎滑脱是互为因果的关系，手术治疗保持了脊椎瞬时旋转中心的正常应力范围，维持了脊柱各方向近期和远期的力学稳定性，能取得很理想的近远期疗效。
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