应用钛合金钉板系统治疗腰椎滑脱的效果  

Treatment of spondylolysis and spondylolisthesis with posterior STB thoracolumbar transpedicular screw plate spine fixation system

作　　者：陈建庭[1] 金大地[1] 瞿东滨[1] 江建明[1] 王吉兴[1] 

机构地区：[1]第一军医大学南方医院骨科,广州510515

出　　处：《中华外科杂志》2003年第8期578-580,共3页Chinese Journal of Surgery

摘　　要：目的　观察一种椎弓根钉板系统STBTM钛合金钉板系统治疗腰椎滑脱的复位及固定效果。　方法　从 1999年 10月～ 2 0 0 1年 1月收治 5 1例腰椎滑脱患者 ,年龄 2 2～ 78岁 ,平均 4 7 5岁 ;均有腰痛、跛行及下肢麻木 ,其中男性 14例 ,女性 37例。 15例为退变性滑脱 ,均为Ⅰ、Ⅱ度滑脱。 36例为峡部裂所致的滑脱 ,Ⅰ、Ⅱ度滑脱 34例 ,Ⅲ度滑脱 2例 ;单节段 33例 ,双节段 3例。 4 3例行腰椎管减压及滑脱节段椎间盘切除 ,STBTM钢板内固定术 ,并椎体间植骨或横突间异体脱钙骨植骨 ;8例CT或MR未发现椎管狭窄或脊髓受压 ,只行STBTM钢板内固定术及横突间异体脱钙骨植骨。　结果　手术操作时间 6 0～ 12 0min ,出血 2 0 0～ 5 0 0ml。经过 12～ 2 4个月 ,平均 18 5个月的定期随访 ,全部恢复工作或生活 ,有 3例Ⅱ度滑脱手术后仍残留Ⅰ度滑脱 ;2例Ⅲ度残留Ⅰ度滑脱 ,其余病例达到解剖复位 ;腰痛、跛行及下肢麻木症状消失 ,2例残留骶尾部轻度麻木 ,但手术后 3个月复查麻木消失。结论　STBTM钛合金钉板系统对腰椎滑脱的复位、固定效果满意 。Objective To observe the clinical effect of a self designed posterior STB thoracolumbar transpedicular screw plate system in the treatment of spondylolysis and spondylolisthe. Methods This STB screw plate system is developed with titanium alloy (TC4,Ti6Al4V). During December,1999 and January, 2001, this system was applied in 51 cases, including lumbar spondylolysis and spondylolisthesis(36 cases), degenerative lumbar instability (15 cases).The patients were aged 22 78 years, mean age: 47 5 years; among them there were 14 male cases, 37 female cases; There were 15 cases degenerative spondylolithesis with grade Ⅰ Ⅱ slip, 36 cases of spondylolysis and spondylolisthesis, including 34 cases with grade Ⅰ Ⅱ slips and 2 cases with grade Ⅲ slips; single level of 33 cases, two levels 3 cases. Decompression was performed for the 43 cases with interbody fusion using iliac crest or bilateral lateral fusion using demineralized bone matrix and 8 cases were fixed with denineralized bone matrix fusion without decompression. Results All the operations heeded about 60 120 minutes,and during the operations bleeding amounts were 200 500 ml. The cases completely recovered to work or normal action after 3 months of surgeries. 46 of all cases were achieved to satisfactorily reduction and clinical effect, 5 cases of grade Ⅱ Ⅲ remained incomplete reduction (grade I slip). Conclusion This STB system has advantages of biomechanical stability and reduction capability and its effect in clinical application is undoubtedly positive.

关 键 词：钛合金钉板 手术治疗 腰椎滑脱 内固定 手术方法 

分 类 号：R687[医药卫生—骨科学]