腰椎；退行性不稳；神经根管减压；脊柱椎间融合术；POLAr

后路斜向腰椎关节固定术治疗腰椎退行性不稳

http://www.100md.com 《中国矫形外科杂志》 2006年第11期

腰椎；退行性不稳；神经根管减压；脊柱椎间融合术；POLAr,,腰椎；,退行性不稳；,神经根管减压；,脊柱椎间融合术；,POLAr,1资料与方法,2结果

     摘要：[目的]探讨应用后路斜向腰椎关节固定术(POLAr)治疗腰椎退行性不稳并神经根管狭窄的治疗效果。[方法]采用后路腰椎侧后方对神经根管彻底减压，后路斜向腰椎关节固定术，治疗腰椎退行性不稳并神经根管狭窄患者80例，男28例，女52例；平均年龄585岁；其中融合2个节段者56例，3个节段者20例，4个节段者4例。[结果]全部患者均安全完成手术，未出现神经系统并发症，术前症状完全缓解。经6个月～6 a(平均2 a)随访，除5例患者外都获得了牢固的椎间骨性融合；临床疗效：优62例，良15例，可3例，优良率95%。[结论]采用后路斜向腰椎关节固定术(POLAr)治疗腰椎退行性不稳，能够恢复椎间高度，重建腰椎轴向排列和载荷，能尽可能地保留脊柱后部结构，保持了脊柱的稳定性，植骨融合牢固，POLAr术式是一种有效治疗退变性腰椎不稳神经根管狭窄的手术方法。

    关键词：腰椎；退行性不稳；神经根管减压；脊柱椎间融合术； POLAr

    Application of posterior oblique lumbar arthrodesis(POLAr) methods in degenerated lumbar spine instability with foraminal stenosis∥ZHANG Qiang,ZOU Dewei,MA Huasong,et alDepartment of Orthopaedic,the 306th Hospital,Peoples Liberation Army,Beijing 100101

    Abstract：[Objective]To examine the clinical outcomes of patients with a degenerated lumbar spine instability with foraminal stenosis treated by posterior oblique lumbar arthrodesis(POLAr)The short term and mid term clinical results were evaluated[Method]There were eighty patients (28 male,52 female) with an average age of 565 yearsFrom posterior approach,all patients underwent foraminal stenosis decompression and posterior oblique lumbar arthrodesis(POLAr)The interbody fusion two levels 56 patients,three levels 20 patients,four levels 4 patients[Result]All patients underwent surgery safely without severe complications occurred such as infection and neurological damagesThe average follow up time was 2 years (6 months~ 6 years) with complete relief of symptomsSolid fusion was achieved in all but 5 patients at final follow upThe clinic results:excellent 62 patients,good 15 patients,fair 3 patients95% of the patients obtained successful clinical outcome[Conclusion]The utilizing posterior oblique lumbar arthrodesis(POLAr)can restore the height of disc space and withstand axial loading of the spineWith less invasive and preservation of part of the posterior elements of the lumbar spine and the solid fusion achieved,we consider it a sound procedure for the treatment of unstable degeneration with foraminal stenosis of lumbar spine ......

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