中国临床解剖学杂志 ›› 2019, Vol. 37 ›› Issue (5): 586-589.doi: 10.13418/j.issn.1001-165x.2019.05.021

• 临床研究 • 上一篇    下一篇

神经根二次减压对重度腰椎滑脱症的治疗意义

马铮, 孙博, 陈康, 焦建宝, 陈涛平   

  1. 河北大学附属医院骨科,  河北   保定    071000
  • 收稿日期:2019-01-25 出版日期:2019-09-25 发布日期:2019-09-26
  • 通讯作者: 陈涛平,副主任医师,硕士研究生,E-mail:18603121976 @163.com
  • 作者简介:马铮(1987-),主治医师,研究方向:脊柱外科,Tel:15075266960,Email:mazheng2012@qq.com
  • 基金资助:
    保定市科技计划项目基金资助(18ZF011)

The clinical significance of nerve roots secondary decompression on the therapy of severe spondylolisthesis

MA Zheng, SUN Bo, CHEN Kang, JIAO Jian-bao, CHEN Tao-ping   

  1. Department of Orthopedics, Affiliated Hospital of Hebei University, Baoding 071000, Hebei Province, China
  • Received:2019-01-25 Online:2019-09-25 Published:2019-09-26

摘要: 目的 研究重度腰椎滑脱复位后神经根二次减压对手术效果的影响。  方法 回顾性研究就诊于我院的36例重度腰椎滑脱症患者的临床资料及影像学资料,所有患者均行腰椎后路滑脱复位全椎板减压植骨融合内固定术,术中滑脱复位后再次探查、减压神经根。记录所有患者手术时间、术中出血量,对比所有患者术前、术后3个月、术后2年的VAS评分、Oswestry功能障碍指数(ODI)、日本骨科协会(JOA)评分、滑脱角及滑脱率,评价临床疗效。  结果  手术时间(96±22)min,出血量(152±68)ml,所有患者术后3个月与术前VAS评分、Oswestry功能障碍指数(ODI)、日本骨科协会(JOA)评分、滑脱角及滑脱率比较均有统计学意义(P<0.05),术后2年与术后3个月VAS评分、Oswestry功能障碍指数(ODI)、日本骨科协会(JOA)评分、滑脱角及滑脱率比较均无统计学意义(P>0.05)。  结论 对于重度腰椎滑脱患者行复位后神经根二次减压,可以充分解除神经压迫,获得良好的临床疗效。

关键词: 腰椎滑脱,  神经根二次减压,  椎间融合术,  内固定

Abstract: Objective To study the effect of secondary decompression on nerve roots after surgical treatment for severe isthmic spondylolisthesis. Methods Clinical and imaging data of 36 patients with severe spondylolisthesis were studied retrospectively. All patients were treated with posterior lumbar intebody fusion(PLIF). Implanted pedicle screws and laminectomy decompression were performed  for the nerve roots after reduction of spondylolisthesis again. The surgical duration and intraoperative blood loss of all patients were recorded. The VAS score, Oswestry dysfunction index (ODI), Japanese Orthopaedic Association (JOA) score, spondylolisthesis angle and spondylolisthesis rate of all patients were analyzed before surgery, 3 months and 2 years after surgery to evaluate the clinical efficacy.     Results    Surgical duration was(96±22)min, and volume of blood loss was(152±68)ml. There was significant difference between 3 months after surgery and the preoperative period on VAS score, ODI index, JOA score, spondylolisthesis angle and spondylolisthesis rate (P<0.05). There was no significant difference between 2 years after operation and 3 months after surgery on VAS score, ODI index, JOA score, spondylolisthesis angle and spondylolisthesis rate(P>0.05). Conclusion Secondary decompression on nerve roots for severe spondylolisthesis can relieve nerve compression and get good clinical effect.

Key words: Spondylolisthesis,  Nerve roots secondary decompression,  ,  , Interbody fusion,  , Internal fixation

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