脊柱通用钉棒系统在骶骨肿瘤切除重建中的初步应用  

CLINICAL APPLICATION OF UNIVERSAL SPINE SYSTEM IN RECONSTRUCTION OF LUMBAR SACRUM JOINT AFTER RESECTION OF SACRUM TUMOR

作　　者：颉强[1] 王臻[1] 王岭[1] 郭征[1] 刘继中[1] 戴先文[1] 

机构地区：[1]第四军医大学西京医院骨科,西安710032

出　　处：《中国修复重建外科杂志》2003年第1期13-15,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的　探讨采用脊柱通用系统 (USS)钉棒系统重建骶骨肿瘤切除后腰骶关节稳定性的适应证、手术方法及可行性。　方法　采用 USS钉棒系统 ,临床应用于 9例骶骨肿瘤。切除骶骨肿瘤 ,在脊髓减压范围的上一椎弓根(L3或 L4 或 L5)按常规方法置入椎弓根螺钉 ,将远端螺钉固定于髂骨翼部 ,置金属棒 ,植骨及安放横向连接器。　结果　术后 9例经 7～ 17个月随访 ,MRI检查无 1例肿瘤复发。术前腰骶部疼痛及下肢根性疼痛症状均明显缓解 ,恢复正常负重及行走。无一例出现断钉、断棒或螺钉松动。 X线片检查未发现钉孔扩大、骨盆内聚及腰椎下移 (L5下沉 )。　结论　采用 USS钉棒系统重建骶骨肿瘤切除后腰骶关节稳定性的手术方法简便 ,创伤小 ,并发症少 ,且固定确实。Objective To investigate the operative indications and techniques of the universal spine system (USS) in reconstruction of the stability of the lumbar sacrum joint after resection of sacrum tumor. Methods Nine patients were treated with USS after resection of sacrum tumor. Among them, there were 6 males and 3 females, aged from 34 60 years. The operation could be divided into four main procedures: ① to resect sacrum tumor; ② to insert the pedicle screw into the normal pedicle (L 3 or L 4 or L 5) above the region of laminectomy; ③to insert the lower screw into the iliac plate; ④to put the rods, bone graft and links. Results There was no recurrence of sacrum tumor by MRI examination during 7 17 month follow up. The pains of the lumbar sacrum joint and the spinal nerve root were relieved obviously. The patients could stand and walked normally. There was no loose screw and no fracture of the screw and the rod. There was no appearance of the enlarged screw passage, the lessened pelvis and lowed L 5 spine. Conclusion Reconstruction of the lumbar sacrum joint by the USS after resection of sacrum tumor is a practical operation clinically. It is characterized by the easy manipulation, few complication and stable fixation.

关 键 词：脊柱通用钉棒系统 骶骨肿瘤 骶骨肿瘤切除术 脊柱重建 腰骶关节稳定性 适应证 手术方法 

分 类 号：R738.1[医药卫生—肿瘤]