摘要
【目的】探讨术前动态X线片检查对成人腰椎崩裂性滑脱复位效果的预测价值，为成人腰椎崩裂性滑脱手术的术前决策提供参考依据。【方法】回顾性分析本院应用后路全椎板解压椎弓根钉撑开复位内固定椎间植骨融合术（PLIF）且具有术前动态位X线片的成人腰椎崩裂性滑脱症患者41例，测量术前腰椎正侧位、过屈过伸动态位X线片：计算滑脱率、滑脱角、前屈位滑脱角、后伸位滑脱角与术后正侧位片显示的滑脱复位率。根据术后一周复查X线显示的滑脱复位情况（以复位率80％为标准）分为复住良好组（A组）、复位不佳组（B组），对两组滑脱角、前屈位与侧位片滑脱角变化值、后伸位与侧位片滑脱角变化值进行统计学比较。【结果】A组其31例，B组共10例；两组病例在过屈过伸位与侧位片滑脱角差值相比较差异有显著性（P〈O．05）。【结论】动态位X线的滑脱角的变化能为术者提供滑脱复位是否困难的信息，可以作为滑脱复位效果的预测指标。
[Objective]To explore the value of preoperative dynamic X-ray in predicting the effieay of re- duction of adult lumbar brust spondylolisthesis so as to provide the reference basis for preoperation decision making of the surgery. [MethodslToally 4t cases of adult brust lumbar spondylolisthesis who had preoperative dynamic X-ray film and treated with posterior total laminotomy decompression, transpedicle intervertebral space distraction reduction and lumbar interbody fusion（PLIF） were analyzed retrospectively. Dynamic lateral and anteflesion X-ray examination of lumbar vertebrae before operation were taken. The slipping ratio and an- gle, anteflexion slipping angle, post-extension slipping angle and the reduction ratio of slipping showed on lat- eral projection were calculated. Accoding to the reduction of slipping by X-ray reexamination a week after the operation, all patients werer divided into well reduction group（group A） and bad reduction group（group B）. The slipping angle, the change of anteflexion and lateral slipping angle and the change of post-extension and lateral slipping angle were compared by statistics. [Results] Group A included 31 patients and group B included 10 patients. There were significant differences in the change of anteflexion and lateral slipping angle between two groups（ P 〈0.05）. [Conclusion]The change of slipping angle on dynamic X-ray can provide the informa- tion for surgeons whether lumbar spondylolisthesis can be reducted, and can be taken as an predictive index of reduction efficacy.
出处
《医学临床研究》
CAS
2013年第7期1363-1366,共4页
Journal of Clinical Research
