腰椎间盘突出症与脊椎滑脱的力学分析和手术治疗
Journal of Regional Anatomy and Operative Surgery(2008)
Abstract
目的 用生物力学原理分析椎间盘突出症和脊椎滑脱的病理关系,探讨经后路减压、椎间盘摘除、椎弓根钉固定、椎间体融合的手术方法.方法 52例腰椎间盘突出症和脊椎滑脱患者均有腰痛或同时伴有坐骨神经痛,全部采用后路行半椎板或全椎板切除探查减压、椎间盘摘除、椎间植骨融合、后路短节段椎弓根钉复位内固定术,对手术方法原则和治疗结果进行临床分析.结果 52例手术患者中按Stamffer疗效标准,良好48例,尚可4例,良好率达92.3%.结论 由于脊椎瞬时旋转中心(instantaneous center of rotation,ICR)应力点的异常,腰椎间盘突出症和脊椎滑脱在病理上是互为因果的.该手术治疗保持了ICR的正常应力范围,减少了脊椎前滑力,维持了脊柱各方向近期和远期的力学稳定性.
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Key words
spondylolisthesis,operation,prolapse of lumbar intervertebral dise,biomechanics
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