中文摘要：

目的对比椎弓根螺钉复位内固定后单纯植骨融合(PLF)与椎间融合器融合(PLIF)治疗腰椎滑脱症的临床疗效。方法随机选取该院2009年8月至2012年12月住院治疗的腰椎滑脱患者70例,采用随机数字法分为PLF组和PLIF组,PLF组在椎弓根螺钉复位内固定后行单纯植骨融合,PLIF组在椎弓根螺钉复位内固定后行椎间融合器融合,比较两组患者的平均手术时间、术中出血量、并发症发生率、植骨融合率、滑脱率、临床有效率、滑脱节段前凸角以及椎体高度的差异。结果两组平均手术时间、术中出血量和并发症发生率之间无统计学意义(P>0.05),但PLIF组的植骨融合率和临床有效率显著高于PLF组(P<0.05);两组术后1 w和术后1年的滑脱率、滑脱节段前凸角和椎体高度均高于术前(P<0.05),两组术后1 w的滑脱率、滑脱节段前凸角和椎体高度比较差异无统计学差异(P>0.05),但PLIF组术后1年的滑脱率、滑脱节段前凸角和椎体高度均高于PLF组(P<0.05);PLF组有3例患者术后1年出现椎弓根螺钉断裂,1例在术后1年后症状无任何缓解;PLIF组有2例患者出现神经根痛。结论椎弓根螺钉复位内固定后PLF治疗与PLIF治疗均对腰椎滑脱症有效,综合考虑PLIF治疗的疗效优于PLF治疗。

英文摘要：

Objective To compare the clinical efficacy between pedicle screw fixation alone after reset fusion ( PLF) and interbody fusion ( PLIF) in treatment of lumbar spondylolisthesis.Methods 70 patients with lumbar spondylolisthes were randomly divided into PLF and PLIF groups, PLF group within the pedicle screw reset fixed underwent pure fusion, PLIF group interbody fusion and pedicle screw fixa-tion underwent in the reset, the average operative time, blood loss, complication rates, fusion rate, slip rate, clinical efficiency, slip out of line segment lordosis angle and vertebral height of two groups were compared.Results The average operative time,blood loss and complica-tion rates between the two groups had no statistically significant differences(P>0.05), but the fusion rate and clinical efficiency of PLIF group were significantly higher than those of PLF group (P<0.05);postoperative l weeks and 1 year ,the slip rate, slip out of line segment lordosis angle and vertebral height of two groups were higher than those of preoperative (P<0.05), postoperative 1 weeks ,the slip rate, slip out of line segment lordosis angle and vertebral height of two groups had no significant difference (P>0.05), but postoperative one year,the slip rate, slip out of line segment lordosis angle and vertebral height of the PLIF group were higher than those of PLF group ( P<0.05);PLF group had 3 cases with pedicle screw breakage postoperative one year, one case without any remission of symptoms postoperative one year;PLIF group 2 patients had radicular pain.Conclusions Pedicle screw fixation after reset PLF and PLIF therapy for the treatment of lumbar spondylolisthesis are effective, the curative effect of PLIF is better than that of PLF in consideration.