植骨加钉-钩固定治疗青年腰椎峡部裂  

Bone grafting and pedicle screw-lamina hook system fixation for treatment of young lumbar spondylolysis

作　　者：李端明[1] 杨洪[1] 庞晓东[1] 高春华[1] 彭宝淦[1] 

机构地区：[1]北京武警总医院脊柱外科,北京100039

出　　处：《脊柱外科杂志》2012年第5期280-283,共4页Journal of Spinal Surgery

摘　　要：目的探讨应用植骨加椎弓根钉-椎板钩系统固定治疗青年腰椎峡部裂的临床疗效。方法 2005年12月～2011年9月,应用植骨加椎弓根钉-椎板钩系统固定治疗青年腰椎峡部裂患者82例,患者均主诉反复腰痛>3个月,非手术治疗3～6个月无效,术前腰椎疼痛视觉模拟量表(visual analogue scale,VAS)评分为7.9分。结果术后腰部疼痛症状明显缓解,VAS评分1.5分,根据Nakai评分标准,优良率为95%,随访12～48个月,除1例峡部裂植骨未愈合外,均骨性融合,无内固定松动、断裂。结论腰椎峡部修复植骨、椎弓根钉-椎板钩系统单节段固定是治疗青年腰椎峡部裂的一种简单、安全、有效的方法,避免了脊柱融合,应用时注意适应证的选择。Objective To explore the clinical outcome of spondylolysis in young patients after treatment with direct repairing bone grafting and pedicle screw-lamina hook system fixation.Methods Between December 2005 and September 2011,a total of 82 young lumbar spondylolysis patients were treated by direct repairing bone grafting and pedicle screw-lamina hook system fixation.All the patients suffered from severe back pain for more than three months,and conservative management（3-6 months） was ineffective.The average visual analogue scale（VAS） score was 7.9 before operation.Results All the patients were followed-up for more than 12 months（12-48 months）.The back pain was relieved in all cases,with the postoperative VAS score being 1.5.The satisfactory rate was 95% according to Nakai classification.The bony healing was achieved in 81 cases,and only 1 case failed to achieve bony fusion due to alloreactive bone grafting.No pedicle screw-lamina hook breakage or loose was found.Conclusion Direct repairing bone grafting and pedicle screw-lamina hook system fixation is an effective,safe and simple single segment fixation for young lumbar spondylolysis.The indications should be controlled properly to avoid lumbar fusion.

关 键 词：腰椎 脊柱滑脱 骨移植 内固定器 

分 类 号：R684.79[医药卫生—骨科学]