椎弓根钉-椎板钩系统固定治疗青年腰椎峡部裂的疗效分析

目的探讨利用椎弓根钉-椎板钩系统固定治疗青年腰椎峡部裂的可行性及临床应用价值。方法回顾分析利用椎弓根钉-椎板钩系统治疗青年腰椎峡部裂19例,对比观察患者实施手术前、后患者骨痛评分、脊柱稳定性的改变以及不良反应。结果 19例患者均获随访,时间12～52个月,平均22.3个月,经X线及CT检查,19例患者椎弓根峡部均获得骨性融合,未见骨不连及内固定断裂,脊柱稳定性好。术前患者疼痛评分为(9.7±2.1)分,术后为(0.4±0.1)分,疼痛明显缓解(P0.05)。结论在严格掌握手术适应证的前提下,椎弓根钉-椎板钩系统固定治疗青年腰椎峡部裂的较好选择,可以尽可能多地保留了脊柱后部结构,避免了医源性的脊柱失稳,术后椎节即刻获得稳定并保留了病椎相邻椎间盘的活动度,取得了满意的临床疗效。

Curative effect of treating the adolescent lumbar spondylolysis by a pedicle screw- lamina hook system

Objective To study the feasibility of a pedicle screw-lamina hook system applied to treat the adolescent lumbar spondylolysis.Methods Nineteen adolescent patients with lumbar spondylolysis were treated with a pedicle screw-lamina hook system.The score of the pain of the bone,stabilization of the vertebral column and toxic effect were compared between the before and after treatment.Results All the 19 patients were followed up with a mean period of 22.3 months,ranging from 12 to 52 months.All the patients had bony union according to the X rays and CT scan,the stabilization of the vertebral column was good.The score of the pain of the bone before treatment(9.7 ±2.1) and after treatment(0.4±0.1)showed significant changes(P < 0.05,t = 1.68).Conclusion This study has shown that a pedicle screw-lamina hook system is preferable to the treatment of adolescent lumbar spondylolysis.This procedure preserves more posterior structures of spine and avoids iatrogenic instability of spine.The immediate postoperative stability of vertebral segment is acquired and the mobility of adjacent intervertebral discs is reserved.The pedicle screw-lamina hook system for the treatment of adolescent spondylolisthesis can get satisfactory clinical results.