标题：半椎板减压联合椎间植骨融合和单侧椎弓根

      作者：内固定治疗腰椎管狭窄症伴退变性Ⅰ度滑脱34例疗效观察
    李德平，毛 波，潘伟明，娄 冰，李 军，熊 亮，张大保
(佛山市第五人民医院骨科佛山科技学院附属医院，广东 佛山 258511)

      卷次： 2014年25卷18期

      【摘要】 目的 观察腰椎管狭窄症伴退变性Ⅰ度滑脱患者经半椎板减压+椎间植骨融合(单枚Cage)+单侧
椎弓根内固定术治疗的临床效果。方法 回顾分析2008年3月至2012年3月收治的34例诊断为腰椎管狭窄症
伴退变性Ⅰ度滑脱的患者，平均年龄(63.4±7)岁，平均病程(48±8)个月。病变平面：L4~5 20例、L5~S1 14例。均应用
半椎板减压+椎间植骨+单侧椎弓根内固定手术方法。采用北美脊柱外科协会的腰椎功能障碍指数(ODI)评价术
后3、12个月腰椎功能改善率；采用疼痛视觉模拟评分法(VAS)对术前、术后3、6、12个月随访时的腰痛及腿痛症
状进行评分，并对结果进行统计学分析。结果 本组 28例患者获得随访，随访时间 12~42个月，平均(26±5)个
月。术后 3、12个月功能改善优良率分别为 89.3%、85.8%。术后功能 3个月及 12个月比较差异无统计学意义
(P>0.05)。术后 3个月腰腿痛VAS评分较术前明显减少(P<0.01)，术后 3、6、12个月比较差异均无统计学意义
(P>0.05)。5例患者发生并发症，其中硬脊膜撕裂3例、神经根损伤1例、切口感染1例。随访12个月全部椎间植
骨融合没有滑脱及内固定断裂发生。结论 腰椎管狭窄症伴退变性Ⅰ度滑脱患者，采用半椎板减压+椎间融合+
单侧椎弓根内固定治疗可获得满意的临床效果。

      【关键词】 腰椎管狭窄症；退变性滑脱；椎板减压；脊柱融合；椎弓根钉；内固定

      【中图分类号】 R681.5+7 【文献标识码】 A 【文章编号】 1003—6350（2014）18—2747—03


Effect of unilateral laminectomy combined with spinal fusion and unilateral pedicle screw instrumentation in
the treatment of 34 cases of lumbar spinal stenosis with grade 1 degengrative spondylisthesis.
LI De-ping, MAO
Bo, PAN Wei-ming, LOU Bing, LI Jun, XIONG Liang, ZHANG Da-bao. Department of Orthopedics, No.5 People's
Hospitital of Foshan, the Affiliated Hospital of Foshan Technical College, Foshan 528211, Guangdong, CHINA

【Abstract】 Objective To investigate the clinical results of unilateral laminectomy combined with spinal fu-
sion and unilateral pedicle screw instrumentation in the treatment of 34 cases of lumbar spinal stenosis with grade 1 de-
gengrative spondylisthesis. Methods From March 2008 to March 2012, 34 patients with degenerative lumbar spinal
stenosis with grade 1 degengrative spondylisthesis were enrolled in a restrospective study to investigate the outcome
of surgical treatment: the average age was (63.4±7) year, and the average history was (48±8) months. All patients were
treated by unilateral laminectomy combined with spinal fusion and unilateral pedicle screw instrumentation. Clinical
outcomes were evaluated by oswestry disability index (ODI) at 3, 12 months after the operation, and low back and
leg pain were evaluated by visual analogue scale (VAS) scores at pre-operation and post-operation at 3, 6, 12 months.
Results 28 patients were followed up for 12 to 42 months with a mean period of (26±5) months. According to the
standardization of oswestry disability index (ODI), the excellent good rate was 89.3% and 85.8% at 3, 12 months re-
spectively after operation (P>0.05). The VAS score of low back pain and leg pain at 3 month postoperative was lower
than at preoperative (P<0.01), and there was on significant difference among 3, 6, 12 months (P>0.05). Five patients
showed complications, including dural tearing in 3 patients, nerve root impingement in 1 patient, and wound infection