植骨联合短期钉棒固定对腰椎峡部裂患者术后疼痛及骨性愈合情况的影响  

Effect of Isthmus Bone Grafting Combined with Short-Term Nail Rod Fixation on Postoperative Pain and Isthmus Bone Healing in Patients with Lumbar Spondylolysis

作　　者：吴鸿雁 郭萍 孙小航 王亚红 袁国栋 朱泽兴 WU Hongyan;GUO Ping;SUN Xiaohang;WANG Yahong;YUAN Guodong;ZHU Zexing(Department of Orthopaedics,988 Hospital of PLA Joint Service Support Force,Zhengzhou 450000,China)

机构地区：[1]中国人民解放军联勤保障部队第九八八医院骨科,河南郑州450000

出　　处：《中国伤残医学》2025年第4期1-5,共5页Chinese Journal of Trauma and Disability Medicine

基　　金：基层部队腰椎峡部裂的筛查及防治研究(LHGJ20220913)。

摘　　要：目的:探讨峡部植骨联合短期钉棒固定在腰椎峡部裂患者中的应用效果。方法:选取2022年2月—2023年10月中国人民解放军联勤保障部队第九八八医院收治的102例腰椎峡部裂患者为研究对象,按随机数字表法将其分为对照组及研究组,各51例。对照组行峡部植骨联合直棒折弯固定治疗,研究组行峡部植骨联合短期钉棒固定治疗。比较两组手术情况、疼痛评分、腰椎功能、腰部活动度、生活质量及峡部骨性愈合情况。结果:两组的手术时间、术中出血量、住院时间比较,差异均无统计学意义(P>0.05)。术后1年,研究组的疼痛视觉模拟评分、Oswestry功能障碍指数评分均低于对照组,差异均有统计学意义(P<0.05)。术后1年,研究组的腰部屈曲、后伸、侧屈及旋转活动度均大于对照组,差异均有统计学意义(P<0.05)。术后1年,研究组的世界卫生组织生活质量评定量表简表中各个领域评分均高于对照组,差异均有统计学意义(P<0.05)。研究组的峡部骨性愈合率为96.08%,高于对照组的84.31%,差异有统计学意义(P<0.05)。结论:峡部植骨联合短期钉棒固定治疗腰椎峡部裂的效果更佳,可提高峡部骨性愈合率,降低患者的术后疼痛评分,减轻其腰部功能障碍,具有较高的应用价值。Objective:To investigate the effect of isthmic bone grafting combined with short-term nail rod fixation in patients with lumbar spondylolysis.Methods:A total of 102 patients with lumbar spondylolysis admitted to 988 Hospital of PLA Joint Service Support Force from February 2022 to October 2023 were selected as the study objects,and were divided into a control group and a study group according to random number table method,with 51 cases in each group.The control group received isthmus bone grafting combined with straight rod bending and fixation,and the study group received isthmus bone grafting combined with short-term nail rod fixation.The surgical status,pain score,lumbar vertebral function,lumbar motion,quality of life and isthmus bone healing were compared between the two groups.Results:There were no significant differences in the operation time,intraoperative blood loss and hospital stay between the two groups(P>0.05).1 year after surgery,the scores of Pain Visual Analogue Scale and Oswestry Disability Index of the study group were lower than those of the control group,the differences were statistically significant(P<0.05).1 year after surgery,the lumbar flexion,extension,lateral flexion and rotation of the study group were higher than those of the control group,the differences were statistically significant(P<0.05).1 year after surgery,the scores in all fields of the World Health Organization Quality of Life-BREF scale in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).The healing rate of isthmus bone in the study group was 96.08%,which was higher than 84.31%in the control group,the difference was statistically significant(P<0.05).Conclusion:Isthmus bone grafting combined with short-term nail rod fixation is more effective in the treatment of lumbar spondylolysis,which can improve the healing rate of isthmus bone,reduce the postoperative pain degree of patients and alleviate their lumbar dysfunction,and has high application value.

关 键 词：腰椎峡部裂 峡部植骨 短期钉棒固定 术后疼痛 峡部骨性愈合 

分 类 号：R687.3[医药卫生—骨科学]