目的 探讨经前路髓核摘除、植骨融合并前路钛板内固定治疗腰骶失稳的早期疗效.方法 采用前路髓核摘除或病灶清除、椎间融合并前路重建钛板固定治疗30例原发或继发性腰骶失稳的患者.结果 患者均获得随访,时间1~2年.随访期间除1例滑脱复位丢失外,其余椎体滑脱患者椎体复位良好、无丢失.继发性腰骶失稳患者病灶清除彻底,植骨融合愈合良好.术后功能根据Nakai评分标准评价:优18例,良8例,可3例,差1例,优良率86.7%.结论 采用前路髓核摘除或病灶清除、椎体植骨融合、腰骶椎重建可获得满意复位,腰骶融合稳定,能够恢复脊柱稳定性.%Objective To explore the early clinical curative effect of anterior surgery for removal of nucleus pulposus, bone graft fusion and anterior titanium plate internal fixation in the treatment of lumbosacral instability.Methods Thirty cases of primary or secondary lumbosacral instability of mechanical low back pain were treated by anterior excision or lesion of nucleus pulposus removal, intervertebral fusion and anterior reconstruction titanium plate fixation surgery.Results All cases got follow-up of 1~2 years.During follow-up period, except for 1 case of slippage reduction lost, the rest of the patients′ clinical symptoms disappeared basically, patients with vertebral slippage slippage vertebral reset was good, no loss, secondary instability lesions in patients with lumbosacral cleared thoroughly, bone graft healed well.According to the Nakai score: excellent 18 cases, good 8 cases, fair 3 cases, poor 1 case, excellent and good rate was 86.7%.Conclusions Using anterior excision or lesion of nucleus pulposus removal, vertebral body bone graft fusion and lumbosacral vertebral reconstruction can satisfy the instability of the vertebral body restoration, stable lumbosacral fusion, restore spinal stability.
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