应用钛合金钉板系统治疗腰椎滑脱的效果

目的 观察一种椎弓根钉板系统STB^TM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-2001年1月收治51例腰椎滑脱患者,年龄22～78岁,平均47．5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。43例行腰椎管减压及滑脱节段椎间盘切除,STB^TM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STB^TM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60～120min,出血200～500ml。经过12～24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 STB^TM钛合金钉板系统对腰椎滑脱的复位、固定效果满意,操作简单。

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

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 demineralized 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.