峡部螺钉联合非融合椎弓钉固定腰椎峡部裂  

Isthmic screw combined with non-fusion pedicle screw fixation for lumbar spondylolysis

作　　者：金新蒙 周文超 徐波[1] 叶维光 范鑫斌[1] 邵进[1] 张岩[1] 刘树义[1] 杨铁毅[1] JIN Xin-meng;ZHOU Wen-chao;XU Bo;YE Wei-guang;FAN Xin-bin;SHAO Jin;ZHANG Yan;LIU Shu-yi;YANG Tie-yi(Gongli Hospital of Pudong New Ar-ea,Shanghai200135,China;Department of Orthopaedics,The First People's Hospital,Shanghai Jiao Tong University,Shanghai 200080,China)

机构地区：[1]上海市浦东新区公利医院,上海200135 [2]上海交通大学附属第一人民医院骨科,上海200080

出　　处：《中国矫形外科杂志》2022年第19期1802-1805,共4页Orthopedic Journal of China

基　　金：上海市浦东新区医学学科建设项目(编号:PWYts2018-03);上海市浦东新区卫生和计划生育委员会重点学科项目(编号:PWZxk2017-18)。

摘　　要：[目的] 探讨峡部螺钉结合非融合椎弓钉固定治疗腰椎峡部裂的临床疗效。[方法] 2015年1月-2019年6月,应用峡部螺钉结合非融合椎弓钉固定治疗腰椎峡部裂或伴Ⅰ度滑脱或盘源性腰痛的患者21例,观察临床与影像结果。[结果] 21例患者均顺利完成手术,术中无血管、神经损伤、脑脊液漏等并发症发生,手术时间平均(130.15±29.72)min,术中出血量平均(215.64±58.51)ml。所有患者均获随访(32.62±9.43)个月,随时间推移,患者VAS和ODI评分较术前明显减少(P<0.05)。术后18个月峡部裂骨性融合率为100%。末次随访时UCLA系统评价与术前相同,未发现邻近节段退变加重情况。[结论] 峡部螺钉结合非融合椎弓钉固定治疗腰椎峡部裂或伴Ⅰ度滑脱或盘源性腰痛是安全有效的,峡部融合率满意。[Objective] To investigate the clinical outcome of isthmic screw combined with non-fusion pedicle screw fixation for lumbar spondylolysis. [Methods] From January 2015 to June 2019, 21 patients underwent isthmic screw combined with non-fusion pedicle screw fixation for lumbar spondylolysis accompanied with or without grade Ⅰ spondylolisthesis or discogenic low back pain. Clinical and imaging results were observed. [Results] All the 21 patients had operation completed successfully, without neurovascular injury, cerebrospinal fluid leakage and other complication, while with operation time of(130.15±29.72) min and intraoperative blood loss of(215.64±58.51) ml on average. With time of follow-up lasted for(32.62±9.43) months, the VAS and ODI scores significantly decreased(P<0.05). Radiographically,the fusion rate of isthmic defect was of 100% 18 months after operation, whereas no deterioration of adjacent-segment degeneration was noticed at the latest follow-up compared with that preoperatively in term of UCLA criteria. [Conclusion] Isthmic screw combined with non-fusion pedicle screw fixation is a safe and effective treatment for lumbar spondylolisthesis with or without grade I spondylolisthesis and discogenic low back pain with a satisfactory fusion rate of the isthmic defect.

关 键 词：腰椎峡部裂 腰椎滑脱 非融合椎弓根固定 峡部固定 盘源性腰痛 

分 类 号：R681.57[医药卫生—骨科学]