急性创伤性腰椎滑脱症的临床特点和手术疗效分析
腰椎滑脱症,,腰椎滑脱症；创伤；骨折；椎间融合术,临床资料,1一般资料,2症状及体征,3影像学检查,4手术方法,结果,1一般情况,2疗效评价,讨论
摘要：目的 总结急性创伤性腰椎滑脱症的临床特点，并观察手术治疗的效果。方法 回顾性分析2000年1月～2004年6月收治6例创伤性腰椎滑脱症的临床资料，通过6～28个月随访，观察经后路内固定、椎间及后外侧融合术的疗效。结果 6例均为L5椎体滑脱；4例因治疗合并伤漏诊腰椎滑脱而使之成为陈旧性损伤；2例曾在外院行腰椎后外侧内固定术失败。术后腰痛症状完全缓解，1例翻修发生一过性神经根不全功能障碍；术后X线片示5例解剖复位(83.3%)，融合率为100%。结论 急性创伤性腰椎滑脱均为严重创伤所致，易发生在L5，因合并伤而致早期漏诊率高。经后路内固定、椎间及后外侧融合术有望获得良好的临床疗效。关键词：腰椎滑脱症；创伤；骨折；椎间融合术
Clinical charateristics and operative treatment of lumbar spondylolisthesis due to acute fracture
LIU Peng,ZHAO Jianhua,FAN Weili,et al.
(Department of Orthopaedics,Institute of Surgery Research,Daping Hospital,Third Military Medical University,Chongqing 400042，China)
Abstract：Objective To summarize the clinical characteristics of traumatic lumbar spondylolisthesis due to actue fracture,and observe the effect of operative treatment.Methods A retrospective study was designed.Data of six patients hospitalized between Jan,2000 and Jun,2004 were collected and analyzed.To observe the effect of the operation of interbody and posterolateral fusion,internal fixation via posterior approach by the followup of six to twentyeight months.Results The vertebrae of olisthy were L5 in all patients.Four cases were old injury due to missed diagnosis.Two patients underwent posterior internal fixation and failed,and they underwent revision surgeries.All patients got total remittence of pain postoperatively,and transient impairment of nerve root occurred in one case.Postoperative Xray showed completed reduction was gained in five cases(83.3%) and fusion rate was 100%.Conclusion Traumatic spondylolisthesis due to actue fracture is a sort of severe trauma and almost occur at fifth lumbar only.It is easily missed at the early stage of trauma.Interbody and posterolateral fusion,internal fixation via posterior approach could meet the demands of treatment. ......
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