【摘要】：背景:目前關(guān)于滑脫椎體是否需要復(fù)位臨床存在一定爭議。目的:觀察椎弓根螺釘內(nèi)固定聯(lián)合腰椎后路椎間融合(PLIF)治療70歲以上高齡退行性腰椎滑脫癥患者的手術(shù)療效。方法:回顧性分析30例70歲以上高齡退行性腰椎滑脫癥患者采用腰椎后路椎弓根內(nèi)固定術(shù)、減壓聯(lián)合椎體間融合治療的臨床資料。對(duì)內(nèi)固定前后的疼痛目測類比評(píng)分,Oswestry功能障礙指數(shù)(ODI)和日本骨科學(xué)會(huì)(JOA)腰椎評(píng)分進(jìn)行比較分析。結(jié)果與結(jié)論:(1)30例患者男12例,女18例,平均年齡為(75.1±6.7)歲。所有患者均順利完成手術(shù),隨訪時(shí)間均在12個(gè)月以上;(2)內(nèi)固定后目測類比評(píng)分為顯著優(yōu)于內(nèi)固定前(P0.05);內(nèi)固定后ODI指數(shù)與腰椎JOA評(píng)分較內(nèi)固定前有明顯改善(P0.05);腰椎JOA評(píng)分改善率情況:治愈3例,顯著有效24例,有效3例,無效0例;(3)根據(jù)椎間融合判定標(biāo)準(zhǔn),所有患者均達(dá)到骨性融合,平均融合時(shí)間為(5.13±0.65)個(gè)月(4-8個(gè)月);(4)平均手術(shù)時(shí)間(225.6±23.4)min,平均術(shù)中出血量(470±45.5)mL。平均隨訪時(shí)間為(25.8±3.5)個(gè)月;(5)手術(shù)相關(guān)并發(fā)癥共有6例(20%),其中1例硬膜囊撕裂,2例麻痹性腸梗阻,3例一過性下肢神經(jīng)癥狀加重;(6)結(jié)果說明,在積極控制全身伴發(fā)疾病的基礎(chǔ)上,椎弓根螺釘內(nèi)固定聯(lián)合椎體間融合治療高齡退行性腰椎滑脫可取得良好的手術(shù)效果。
[Abstract]:Background: at present, there is some controversy about whether spondylolisthesis needs to be reduced clinically. Objective: to observe the surgical effect of pedicle screw fixation combined with posterior lumbar intervertebral fusion (PLIF) in the treatment of degenerative lumbar spondylolisthesis over 70 years old. Methods: the clinical data of 30 patients over 70 years old with degenerative lumbar spondylolisthesis treated with posterior pedicle internal fixation of lumbar vertebrae and decompression combined with interbody fusion were analyzed retrospectively. the clinical data of 30 patients with degenerative lumbar spondylolisthesis over 70 years old were analyzed retrospectively. The pain visual analogy score, Oswestry dysfunction index (ODI) and (JOA) lumbar vertebrae score before and after internal fixation were compared and analyzed. Results and conclusion: (1) there were 12 males and 18 females with an average age of (75.1 鹵6.7) years. All the patients completed the operation successfully and the follow-up time was more than 12 months. (2) the visual analogy score after internal fixation was significantly better than that before internal fixation (P 0.05). The ODI index and lumbar JOA score after internal fixation were significantly improved compared with those before internal fixation (P 0.05), and the improvement rate of lumbar JOA score was cured in 3 cases, significantly effective in 24 cases, effective in 3 cases and ineffective in 0 cases. (3) according to the criteria of intervertebral fusion, all patients reached bone fusion, and the average fusion time was (5.13 鹵0.65) months (4 鈮，

本文編號(hào)：2479860