植骨加钉-钩固定治疗青年腰椎峡部裂

目的探讨应用植骨加椎弓根钉-椎板钩系统固定治疗青年腰椎峡部裂的临床疗效。方法 2005年12月～2011年9月,应用植骨加椎弓根钉-椎板钩系统固定治疗青年腰椎峡部裂患者82例,患者均主诉反复腰痛〉3个月,非手术治疗3～6个月无效,术前腰椎疼痛视觉模拟量表（visual analogue scale,VAS）评分为7.9分。结果术后腰部疼痛症状明显缓解,VAS评分1.5分,根据Nakai评分标准,优良率为95%,随访12～48个月,除1例峡部裂植骨未愈合外,均骨性融合,无内固定松动、断裂。结论腰椎峡部修复植骨、椎弓根钉-椎板钩系统单节段固定是治疗青年腰椎峡部裂的一种简单、安全、有效的方法,避免了脊柱融合,应用时注意适应证的选择。

Bone grafting and pedicle screw-lamina hook system fixation for treatment of young lumbar spondylolysis

Objective To explore the clinical outcome of spondylolysis in young patients after treatment with direct repairing bone grafting and pedicle screw-lamina hook system fixation.Methods Between December 2005 and September 2011,a total of 82 young lumbar spondylolysis patients were treated by direct repairing bone grafting and pedicle screw-lamina hook system fixation.All the patients suffered from severe back pain for more than three months,and conservative management（3-6 months） was ineffective.The average visual analogue scale（VAS） score was 7.9 before operation.Results All the patients were followed-up for more than 12 months（12-48 months）.The back pain was relieved in all cases,with the postoperative VAS score being 1.5.The satisfactory rate was 95% according to Nakai classification.The bony healing was achieved in 81 cases,and only 1 case failed to achieve bony fusion due to alloreactive bone grafting.No pedicle screw-lamina hook breakage or loose was found.Conclusion Direct repairing bone grafting and pedicle screw-lamina hook system fixation is an effective,safe and simple single segment fixation for young lumbar spondylolysis.The indications should be controlled properly to avoid lumbar fusion.