椎弓根钉-椎板钩系统和经椎板拉力螺钉治疗青少年腰椎峡部裂的临床比较  

Clinical comparison of pedicle screw hook fixation with translaminar lag screw fixation for surgical repair of spondylolysis in Adolescents

作　　者：张建党[1] 邹德威[1] 马华松[1] 谭荣[1] 彭军[1] 王蒙[1] 张峥[1] 张墨[1] 

机构地区：[1]中国人民解放军第306医院骨科三病区,北京100101

出　　处：《中国现代医药杂志》2010年第11期69-71,共3页Modern Medicine Journal of China

摘　　要：目的回顾性比较研究椎弓根钉-椎板钩系统和经椎板拉力螺钉治疗青少年腰椎峡部裂的临床疗效。方法从1999年1月～2008年12月,我院应用椎弓根钉-椎板钩节段内固定及植骨修复重建青少年腰椎峡部裂38例。经椎板拉力螺钉修复重建青少年腰椎峡部裂28例。从手术时间、术中失血量和术后效果对两种手术方式进行比较。结果在手术时间、术中失血量方面,椎弓根钉-椎板钩系统优于经椎板拉力螺钉;并发症方面,椎弓根钉-椎板钩系统脱钩1例,经椎板拉力螺钉系统神经根损伤1例。按MacNab标准评价术后效果,椎弓根钉-椎板钩系统的优良率为94.6%,经椎板拉力螺钉的优良率为92.6%,椎弓根钉-椎板钩系统与经椎板拉力螺钉的疗效无明显差异。结论椎弓根钉-椎板钩系统及植骨修复重建青少年腰椎峡部裂手术操作容易,失血量少,固定可靠,安全性高,效果确实。推荐使用椎弓根钉-椎板钩系统修复重建青少年腰椎峡部裂。Objective To compare retrospectively the clinical outcome of pedicle screw hook fixation with translaminar lag screw fixation for surgical repair of spondylolysis in adolescents.Methods 66 young cases with lumbar spondylolysis were repaired by pedicle screw hook fixation（38 cases） or translaminar screw fixation（28 cases） between Jan 1999 and Dec 2008.Operation time,intraoperative blood loss and postoperative outcome were compared between the two fixation techniques.Results Translaminar lag screw fixation was more extensive procedures with significantly longer operation time and greater intraoperative blood loss and more severe complication than pedicle screw hook fixation,although the two techniques had the similar excellent/good rate,92.6% vs 94.6% according to MacNab criteria.Conclusion Pedicle screw hook fixation was a good alternative for repair spondylolysis in adolescents with technical simplicity,fewer blood loss,more safety and good clinical outcomes.

关 键 词：峡部裂 椎弓根钉-椎板钩系统 拉力螺丝钉 

分 类 号：R687.3[医药卫生—骨科学]