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腰椎峡部裂的治疗进展

     

摘要

BACKGROUND: Lumbar spondylolysis is typically caused by a stress fracture of the bone, especially for who over-train in activities. Besides, there is hereditary that can make one more susceptible to the defect. The treatment methods include conservative management and surgery, both with their own indications, advantages,disadvantages and prognosis.OBJECTIVE: To summarize the range of application, advantages and disadvantages of each treatment method of spondylolysis.METHODS: PubMed, CNKI, and VIP databases were retrieved using the keywords of "spondylolysis, isthmic spondylolisthesis, treatment/therapy" in English and Chinese, respectively. The articles were grouped based on the treatment method after skimming the abstract, and then the indications, operative principles, and advantages/disadvantages were recorded.RESULTS AND CONCLUSION: Surgeries of spondylolysis are classified as interbody fusion, Buck's method, Scott's fusion, pedicle screw-hook system, memory alloy plates for internal fixation, segmental fusion and mini-invasive treatment. Among which, Buck's methods and pedicle screw-hook system are widely accepted. Additionally, minimally invasive treatment becomes more and more prevailed.%背景:腰椎峡部裂常由于椎弓承受过度负荷而导致,应力性骨折可为其重要的前提要素之一,或可能伴有遗传倾向.峡部裂的治疗可分为保守治疗和手术治疗两种,各种治疗方案的适用人群、手术要点及预后等均存在着差异.目的:检索现有的有关峡部裂治疗的文献,并对其适用范围、手术优缺点等方面的内容进行综述.方法:通过PubMed、中国知网、VIP等数据库进行文献检索,检索关键词为"峡部裂"(spondylolysis)、"峡部裂型滑脱"(isthmic spondylolisthesis)、"治疗"(treatment/therapy),不限定检索时间.对检索所得文献进行摘要阅读后依据治疗方案进行区组.并记录其适用范围、手术要点、治疗的优缺点等内容.结果和结论:峡部裂的手术治疗又可分为节段内非固定术、Buck峡部螺钉固定法、Scott横突棘突间钢丝捆绑法、椎弓根钉-椎板钩固定法、记忆合金节段内固定法、节段间融合术以及微创治疗等.当前较为广泛应用的治疗方法为Buck法和椎弓根螺钉-椎板钩内固定.峡部裂的微创治疗也越来越受到患者的认可.

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