椎弓根螺钉内固定加单纯椎体间植骨融合治疗下腰椎不稳症  

Treatment of lumbar spinal instability using transpedicular screw fixation combined with interbody spinal fusion with auto iliac bone grafting

作　　者：滕红林[1] 贾连顺[2] 肖建如[2] 袁文[2] 陈德玉[2] 荆鑫[2] 章允志[2] 叶澄宇[1] 杨胜武[1] 

机构地区：[1]温州医学院附属第一医院,浙江温州325000 [2]长征医院

出　　处：《中国骨伤》2002年第12期718-720,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的 评价椎弓根内固定、椎体间植骨融合术在治疗下腰椎不稳症中的应用及其临床效果。方法 对27例腰椎不稳的患者行后路经椎弓根内固定加单纯后路或前路椎体间自体髂骨植骨融合术。其不稳节段分别在L3,4,L4,5和L5S1。手术指征以临床症状、体征为主,结合与临床相一致的影像学检查。结果 27例患者随访10～44个月平均21.9个月。本组除1例患者术后出现暂时性的神经根牵拉症状外,其余患者术后无神经功能恶化,病情均获不同程度减轻。随访期间椎体间植骨骨性愈合,无椎间高度及复位丢失,无其它远期并发症出现。结论 椎弓根内固定加后路单纯椎体间植骨融合,能提供稳定的生物力学环境,促进椎体间植骨融合,骨性愈合率高,固定牢靠,且经济费用较后路内固定加椎间植骨融合器等有所降低,适用于治疗腰椎不稳症。Objective To evaluate the therapeutic effect of the transpedicular screw fixation combined with interbody fusion by simply auto iliac bone grafting in lumbar spinal instability Methods Twenty-seven patients of lumbar spinal instability were treated with these procedures. The instability segments were at the L3,4,L4,5 and L3S1 levels respectively. The indication for fusion surgery is mainly based on the clinical manifestation and the radiographs abnormal findings consistent with the clinical presentations. Results All the patients were followed-up from 10 to 44 months with an average of 21.9 months, among them, no neurological deterioration occurred except one case with temporarily stretching of the nerve roots; the patients informed that their back and limb pain had completely recovered or markedly diminished. Conclusion The transpedicular screw systems combined with interbody fusion by simply auto iliac bone grafting can provide suitable biome-chanical environment facilitating the interbody solid fusion. Higher fusion rates and good outcome can be achieved;meanwhile, this method is less costly than the transpedicular screw systems combined with interbody fusion cages.

关 键 词：脊柱损伤 骨移植 内固定器 治疗 

分 类 号：R684.7[医药卫生—骨科学]