节段内U形钛棒固定系统结合峡部植骨治疗腰椎峡部裂的临床效果  

Clinical effect of segmental U-shaped titanium rod fixation system combined with isthmus bone grafting in the treatment of lumbar isthmus

作　　者：石林新 吴成如 廖国权 高升 史凤之 俞军卫 孙国荣 陈然 顾庆陟 SHI Lin-xin;WU Cheng-ru;LIAO Guo-quan;GAO Sheng;SHI Feng-zhi;YU Jun-wei;SUN Guo-rong;CHEN Ran;GU Qing-zhi(the Second Department of Orthopaedics,the 901st Hospital of PLA Joint Logistics Support Force,Hefei,Anhui 230031,China)

机构地区：[1]解放军联勤保障部队第九○一医院骨二科,安徽合肥230031

出　　处：《颈腰痛杂志》2021年第6期809-811,共3页The Journal of Cervicodynia and Lumbodynia

基　　金：宁夏回族自治区自然科学基金(编号:NZ16212)。

摘　　要：目的研究U形钛棒内固定系统结合峡部植骨治疗腰椎峡部裂的临床疗效。方法纳入2015年2月~2018年12月本科收治的50例不伴有椎间盘突出及腰椎滑脱的单纯性腰椎峡部裂患者;累及节段L_(3)4例,L_(4)14例,L_(5)32例。采用节段内U形钛棒固定系统结合峡部植骨治疗30例(U形钛棒组),节段间椎弓根螺钉系统结合峡部植骨治疗20例(椎弓根钉组)。对比两组术前及末次随访时的VAS评分、ODI指数以及腰椎活动度以及并发症发生情况。通过腰椎CT评价峡部骨折愈合情况。结果所有患者随访12~24个月,平均(18.2±7.3)个月。末次随访时两组疼痛VAS评分、ODI指数较术前均显著降低(P<0.05),但两组间差异无统计学意义(P>0.05),但U形钛棒组腰椎活动度显著大于椎弓根钉组,差异有统计学意义(P<0.05)。末次随访两组患者峡部裂骨性愈合时间无显著性差异(P>0.05)。所有手术切口均Ⅰ期愈合,植骨骨性融合,无感染、慢性疼痛、内固定松动等并发症发生。结论对于不伴有椎间盘突出及腰椎滑脱的单纯性腰椎峡部裂患者,节段内U形钛棒固定与节段间椎弓根钉固定结合峡部植骨治疗均能取得良好疗效,但前者更有利于保留腰椎的活动度。Objective To investigate the clinical effect of U-shaped titanium screw-rod fixation system combined with isthmus bone grafting in the treatment of lumbar spondylolysis.Methods From February 2015 to December 2018,50 patients with pure lumbar spondylolysis without disc herniation and lumbar spondylolisthesis were included in this study.Among them,4 cases with L_(3) spondylolysis,14 cases with L_(4)spondylolysis and the other 32 cases with L_(5)spondylolysis.Thirty cases were treated with U-shaped titanium screw-rod fixation system combined with isthmus bone grafting,20 cases were treated with segmental pedicle screw system combined with isthmus bone grafting.The VAS score,ODI index and lumbar range of motion of the two groups were compared at preoperation and the last follow-up,and the incidence of complications of the two groups was observed.The healing of spondylolysis was evaluated by lumbar CT.Results All patients were followed up for 12-24 months,with an average of(18.2±7.3)months.At the last follow-up,the pain VAS score and ODI index of the two groups were significantly lower than before operation(P<0.05),but there were no significant differences between the two groups(P>0.05),but the lumbar mobility of the U-shaped titanium rod group was significantly higher than that of the pedicle screw group(P<0.05).At the last follow-up,there was no significant difference in the healing time of isthmus between the two groups(P>0.05).All surgical incisions were healed in primary stage,bone graft and bone fusion,and there were no complications such as infection,chronic pain and loosening of internal fixation.Conclusion For patients with pure lumbar spondylolysis without disc herniation and lumbar spondylolisthesis,both U-shaped titanium screw-rod fixation and U-shaped titanium screw-rod fixation system combined with isthmus can achieve good therapeutic effect.The U-shaped titanium screw-rod fixation system with bone grafting is more conducive to preserve the range of motion of lumbar spine,and the operation is safe and e

关 键 词：腰椎峡部裂 U形钛棒固定系统 峡部植骨 椎弓根钉棒 

分 类 号：R687.3[医药卫生—骨科学]