于海国

[摘要] 目的 探讨腰椎间盘突出症合并椎体滑脱的手术治疗效果。 方法 选取2011年5月～2012年9月于我院就诊的腰椎间盘突出症合并椎体滑脱患者75例，随机分为手术组（38例）和牵拉组（37例）。比较两组的临床疗效及JOA下腰痛评分和并发症发生率。 结果 手术组的优良率为92.11%，明显高于牵拉组的75.68%，差异具有统计学意义（P＜0.05）。术前两组JOA下腰痛评分比较，差异无统计学意义（P＞0.05）；手术组术后JOA下腰痛评分明显高于牵拉组，差异具有统计学意义（P＜0.05）；手术组术后并发症发生率明显低于牵拉组，差异具有统计学意义（P＜0.05）。 结论 手术治疗腰椎间盘突出症合并椎体滑脱的临床疗效显著，具有界面固定稳定、保证椎间隙的高度、融合率高等诸多优点，疗效满意。

[关键词] 腰椎间盘突出症；脊椎滑脱；手术治疗

[中图分类号] R687.3   [文献标识码] B   [文章编号] 2095-0616（2014）08-183-03

Analysis on operation treatment effect of lumbar disc herniation combined with spondylolisthesis

YU Haiguo

Department of Orthopedics, Zhangdian Hospital of Traditional Chinese Medicine in Zibo City,Zibo 255035,China

[Abstract] Objective To explore the operation treatment effect of lumbar disc herniation combined with spondylolisthesis. Methods 75 cases of lumbar disc herniation combined with spondylolisthesis were collected from May 2011 to September 2012 in our hospital,and were randomly divided into operation group(38 cases) and traction group(37 cases). The clinical efficacy, JOA low back pain score and incidence of complications was compared between the two groups. Results The excellent and good rate of operation group was 92.11%,which was significantly higher than 75.68% of traction group, the difference was statistically significant between two groups(P＜0.05). There was no significant difference in JOA low back pain score before operation between two groups(P＞0.05);postoperative JOA low back pain score of operation group was significantly higher than that of traction group, the difference was significant(P＜0.05);postoperative incidence of complications of operation group was significantly lower than that of traction group, the difference was significant(P＜0.05). Conclusion The operation treatment for lumbar disc herniation combined with spondylolisthesis has significant clinical curative effect, and has the advantages with fixed and stable interface, ensuring the height of intervertebral space, high fusion rate.

[Key words] Lumbar disc herniation;Spondylolisthesis;Operation treatment

腰椎间盘突出症合并椎体滑脱临床常见，其约占腰椎间盘突出症的1/5左右。临床确诊需根据临床表现及辅助检查综合评价。引起腰椎间盘突出症的主要原因是外伤因素及退行性变，椎体滑脱的病理基础为椎间盘突出。突出的椎间盘会导致椎间隙的变窄，使得关节囊变得松弛，从而导致了椎体的滑脱[1]。手术是治疗腰椎间盘突出症合并椎体滑脱的主要方法，手术主要是通过生物力学的原理，使脊椎的力学稳定提高性，从而改善临床症状。本研究探讨了腰椎间盘突出症合并椎体滑脱的手术治疗效果，现报道如下。

1 资料与方法

1.1 一般资料

75例腰椎间盘突出症合并椎体滑脱患者于2011年5月～2012年9月就诊于我院，所有患者皆行X线腰椎正、侧位片、CT及MRI检查。……