STB后路椎弓根内固定系统在腰椎不稳外科治疗的应用

目的:报道应用STB胸腰椎椎弓根内固定系统在腰椎不稳治疗中的应用效果。方法:2001年1月～2003年1月间收治18例腰椎不稳患者,平均年龄42.5岁,双侧峡部裂伴腰椎Ⅰ°、Ⅱ°滑脱8例,双侧峡部裂合并椎间盘突出症6例,退变性腰椎不稳4例,单节段14例,双节段4例,均经动力位X线摄片明确有腰椎不稳。手术均采用STB后路椎弓根内固定系统,内固定并横突间植骨融合5例,其余13例行后路减压、椎间盘摘除、椎体间或横突间植骨融合并内固定。结果:随访12～24个月(平均18个月),患者临床症状明显改善,术后3个月全部恢复正常工作或日常活动,X线摄片检查示内固定牢靠,稳定性良好,无松动及断钉。结论:在有效减压及植骨融合基础上,应用STB后路椎弓根内固定系统治疗腰椎不稳具有确切的临床疗效,该系统操作简便,可以满足早期脊柱稳定性重建的生物力学要求。

Treatment of lumbar spine instability with STB transpedicular fixation system

To evaluate the clinical efficacy of STB transpedicular fixation system in the treatment of the lumbar spine instability. Methods: Eighteen patients, aged 42.5 years for average, with lumbar spine instability were treated in our department from Jan.2001 to Jan. 2003, including 8 cases of spondylosis and spondylolisthesis, 6 cases of bilateral spondylosis and disc herniation, and 4 cases of degenerative instability. All those patients with 14 cases suffering from the single-level instability and 4 cases suffering from the double-level instability were examined by dynamic X-ray. STB transpedicular fixation system was used in all cases, accompanied by posterior spine fusion alone or combined with posterior decompression. Results: Followed up for 12 to 24 months, all patients had obvious improvements and recovered to normal work or daily activity. X-ray examination showed excellent lumbar spine stability with this device, and no loosening or breakage of this device was noted. Conclusions: In the treatment of lumbar spine instability, STB transpedicular fixation system applied with effective decompression and spinal fusion has satisfactory results. This device is recommended for its simple structure and favorable biomechanical capacity.