RF提拉钉复位固定减压原位植骨融合治疗腰椎滑脱37例

目的探讨用R FⅡ、Ⅲ型提拉钉复位,减压、植骨、原位融合治疗腰椎滑脱的临床疗效。方法采用该方法治疗L4或L5滑脱者37例。结果通过平均20个月的随诊,按照侯树勋疗效评定标准,优23例,良9例,可5例。优良率达86.5%,37例病人术后X线示全部骨性愈合。结论对Ⅰ、Ⅱ度腰椎滑脱者,采用R F-Ⅱ、Ⅲ型提拉钉可达到89.2%复位率,是基层医院治疗腰椎滑脱的一种有效方法。     

GSS内固定治疗胸椎包虫病术后复发并瘫痪1例

1 病例资料 患者,女,31岁。2006年3月7日以“胸椎包虫病术后复发并瘫痪”收住院治疗。患者1998年曾因“胸椎包虫病”在我院手术治疗。术后病理检验结果明确诊断为“包虫病”。术后1个月,患者双下肢感觉运动功能完全恢复,3个月后开始行走,并能完成一般家务及轻体力工作。     

半坚强与坚强内固定邻近节段腰椎间盘角位移及应力的比较

BACKGROUND: Theoretically, lumbar semi-rigid fixation can slow down the degeneration of adjacent segments, but there is still a lack of biomechanical support. OBJECTIVE: To explore the biomechanical effect of semi-rigid fixation system, taking Isobar TTL for instance, on adjacent segment disc by means of finite element analysis. METHODS: The finite element models of USS and Isobar TTL were constructed by putting respective parameters into a validated L2-S5 lumbar model. The angular displacement and von Mises stress of adjacent segments were recorded when the models were subjected to 400 N preload and 7.5 N•m moment of forces under different conditions: flexion, extension, lateral bending and axial rotation. RESULTS AND CONCLUSION: The angular displacement and inter-vertebral disc stress of adjacent segments in the USS and Isobar TTL models were higher than those of an intact state in every condition. But the values in Isobar TTL model were lower than the USS model in varying degrees. Compared with the USS model, the decrease rates of angular displacement in Isobar TTL model for flexion, extension, left bending, right bending, left axial rotation and right axial rotation were 19.2%, 15.1%, 11.1%, 12.2%, 18.4% and 22.1%, respectively. The decrease rates of von Mises stress were 33.0%, 20.2%, 23.9%, 18.6%, 28.8% and 28.0%, respectively. The results suggested that the Isobar TTL, when compared with the USS, partially reduced the angular displacement and inter-vertebral disc stress of adjacent segments.