Kho Victor Ka-Siong, Chen Wen-Chih
Division of Orthopedics, Department of Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan, ROC.
Int Orthop. 2008 Feb;32(1):115-9. doi: 10.1007/s00264-006-0274-9. Epub 2006 Dec 19.
We retrospectively reviewed the outcome of posterolateral fusion (PLF) in 136 patients with lumbar spondylolisthesis (LS), who had undergone posterior decompression laminectomy with foraminotomy and PLF using laminectomy bone chips as bone graft, with reduction of the slipped vertebra with transpedicle screws, between 1993 and 2003. Diagnosis of LS was confirmed by plain lumbar radiography, with computed tomography (CT) scan or magnetic resonance imaging (MRI) studies performed to confirm an associated condition, such as ruptured disc and spinal stenosis. The outcome of spinal fusion was good with 129 (94.85%) patients attaining solid fusion, while failed fusion was noted in seven (5.15%) patients. None of our patients complained of excessive postoperative wound pain. Additionally, no complications, such as wound infection, were encountered. Proper decortication of the posterior paravertebral gutters with an osteotome and removal of all soft tissues from the laminectomy bone chips are significant factors contributing to the successful outcome of the laminectomy bone chips in PLF. The fusion rate obtained with this type of autogenous bone graft is comparable to that of the iliac bone crest autogenous graft; hence, it is a good substitute for the iliac crest bone autogenous graft in performing PLF in treating lumbar spondylolisthesis.
我们回顾性分析了1993年至2003年间136例腰椎滑脱（LS）患者行后外侧融合术（PLF）的结果。这些患者均接受了后路减压椎板切除术、椎间孔切开术以及使用椎板切除骨块作为骨移植材料的PLF，并用椎弓根螺钉复位滑脱椎体。通过腰椎X线平片确诊LS，并进行计算机断层扫描（CT）或磁共振成像（MRI）检查以确认相关疾病，如椎间盘破裂和椎管狭窄。脊柱融合效果良好，129例（94.85%）患者实现了牢固融合，7例（5.15%）患者融合失败。我们的患者均未抱怨术后伤口疼痛过度。此外，未出现诸如伤口感染等并发症。用骨刀对椎旁沟后部进行适当的去皮质处理以及从椎板切除骨块上去除所有软组织是椎板切除骨块在PLF中取得成功结果的重要因素。这种自体骨移植获得的融合率与髂嵴自体骨移植相当；因此，在治疗腰椎滑脱行PLF时，它是髂嵴自体骨移植的良好替代物。
