目的：探讨微创扩张通道下椎间融合经皮椎弓根螺钉内固定术在治疗腰椎滑脱疾病中的临床疗效。方法采用微创扩张通道下椎间融合经皮椎弓根螺钉内固定术治疗腰椎滑脱12例，手术均在气管插管全身麻醉下进行，采用俯卧位，棘突旁作1～2 cm 小切口，经微创扩张通道于椎间隙植入融合器植骨融合后，经皮椎弓根螺钉内固定提拉椎体复位。术后定期复查 X 线片以观察固定节段的稳定性和融合情况。结果术后12例全部获得随访，随访6～12个月，平均8个月。滑脱均完全复位，无植骨不融合。内固定节段稳定，腰椎椎间高度及生理曲度都得到良好重建及维持，未出现内固定断裂、松动及脱出，无血管、神经损伤等并发症。结论微创扩张通道下椎间融合经皮椎弓根螺钉内固定术治疗腰椎滑脱，防止了棘突旁肌肉和韧带的剥离，完全恢复腰椎序列，复位良好，是一种积极有效的方法。%Objective Expansion of minimally invasive percutaneous interbody fusion under channel pedicle screw fixa-tion in the treatment of spondylolisthesis in the clinical disease and application value. Methods Minimally invasive lumbar interbody fusion under expansion channel percutaneous pedicle screw fixation of spondylolisthesis in 12 cases,operations were carried out under general anesthesia,the prone position,spinous process for the 1 ~ 2 cm small incision,The minimally invasive expansion of the channel in the intervertebral fusion cage implantation after percutaneous pedicle screw fixation pulling vertebra reduction. After periodic review of X-ray film to observe the stability of a fixed segment,and fusion rate. Results After 12 ca-ses were followed up for 6 to 12 months,an average of 8 months. Slippage are fully reset,no bone graft and fusion. Segmental fixation stability,lumbar intervertebral height and lordosis have been rebuilding and maintaining good,does not appear fracture fixation,loosening and extrusion,without blood vessels,nerve injury. Conclusion Under the expansion of minimally invasive lumbar interbody fusion channel percutaneous pedicle screw fixation of spondylolisthesis,to prevent the spinous process of stripping the muscles and ligaments,lumbar sequence fully restored,good reduction,spinal compression before and after the party has been completely lifted,sliding out of line segment obtained immediately after the stable,low back muscle strength have been protected,can get out of bed early,to facilitate post-operative care and functional training,as a positive and effective ways.
展开▼
