文章摘要
卜祥博1,曲哲1,潘彬1,高啸1,邓斌1,霍添群1,李子昂1,单鸿剑1,冯虎,赵杰2.改良 Jaslow 技术与 PLIF 治疗峡部裂型腰椎滑脱症比较[J].,2019,27(17):1549-1555
改良 Jaslow 技术与 PLIF 治疗峡部裂型腰椎滑脱症比较
Modified Jaslow technique versus PLIF for isthmic spondylolisthesis
投稿时间:2019-04-10  修订日期:2019-05-20
DOI:
中文关键词: 峡性腰椎滑脱症, 改良 Jaslow 技术, 后路椎体间融合术 (PLIF), 失平衡, 腰椎-骨盆矢状面 参数
英文关键词: isthmic spondylolisthesis, modified Jaslow technique, posterior lumbar interbody fusion (PLIF) , unbalanced pelvic, lumbar- pelvic sagittal pa⁃ rameters
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作者单位
卜祥博1  
曲哲1  
潘彬1  
高啸1  
邓斌1  
霍添群1  
李子昂1  
单鸿剑1  
冯虎  
赵杰2  
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中文摘要:
      摘要:[目的]比较改良 Jaslow 技术与 PLIF 治疗峡部裂型腰椎滑脱症的效果。[方法]回顾性分析 2014 年 12 月 ~2017 年 3 月手术治疗的 L5 S1 单节段中、重度峡部裂型腰椎滑脱症患者 87 例。其中 49 例采用改良 Jaslow 技术;38 例采用 PLIF。比较两组临床与影像资料。[结果] 两组患者均顺利手术,Jaslow 组的手术时间、术中出血量、术后 引流量均显著低于 PLIF 组 (P<0.05)。随访 (18.31±2.25) 个月,术后两术式组 JOA、VAS、ODI 评分均显著改善 (P<0.05)。影像方面,采用 K-Means 聚类分析,依据 PT、SS 相对比值分为平衡型和失平衡型。平衡型两术式△ SP、△SA、△LL、△PT、CS 之间差异无统计学意义(P>0.05);而失平衡组中,Jaslow 组的△SP、△SA、△LL、△ PT 均显著大于 PLIF 组 (P<0.05);Jaslow 组中 CS 和 SR 显著低于 PLIF 组 (P<0.05)。[结论] 对于峡部裂型腰椎滑 脱症,改良 Jaslow 技术和 PLIF 同样可获得满意的临床疗效,改良 Jaslow 技术能更有效地恢复腰椎前凸角及矢状位平 衡。
英文摘要:
      Abstract: [Objective] To compare the clinical and radiographic outcomes of the modified Jaslow technique versus posteri? or lumbar interbody fusion (PLIF) for isthmic spondylolisthesis. [Methods] A retrospective study was done on 87 patients who underwent surgical treatment for single L5/S1 -segmental isthmic spondylolisthesis from December 2014 to March 2017 in our department. In term of surgical procedures performed, 49 patients were treated with the modified Jaslow technique, while 38 pa? tients received PLIF. The clinical and radiographic documentations were compared between the two groups. [Results] All the pa? tients had surgical procedures performed smoothly, however, the Jaslow group proved significant superior to the PLIF group in operation time, intraoperative blood loss and postoperative drainage volume (P<0.05) . The follow up period lasted for a mean of (18.31±2.25) months. The VAS, ODI and JOA scores significantly improved in both groups at the latest follow up compared with those before operation (P<0.05) , with no statistically significant differences at any corresponding time points between the two groups (P>0.05) . Regarding to radiographic assessment, the patients were divided into the balanced and unbalanced types based on the relative ratios of PT and SS by K-Means cluster analysis. In balanced type, no statistically significant differences were noticed between the Jaslow group and PLIF group in variations of sagittal balance parameters, including △SP,△SA, △ LL, △PT, the cage subsidence (CS) and subsidence rate (SR) (P>0.05) . In contrast, the Jaslow group prove significantly superi? or to the PLIF group in unbalanced type regarding improvements of aforesaid radiographic parameters (P<0.05) . [Conclusion] For the isthmic spondylolisthesis both the modified Jaslow technique and PLIF do obtain satisfactory clinical results. By compar? ison, the modified Jaslow technique achieves better restoration of the lumbar lordosis and the lumbar- pelvic sagittal balance than the PLIF.
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