摘要:
BACKGROUND: When conservative treatment of pure lumbar spondylolysis is ineffective, segmental fixation and bone grafting is a commonly used method. However, surgical methods are various, and have some controversies. OBJECTIVE: To investigate the effectiveness of U-shape titanium screw-rod fixation system with bone grafting for pure lumbar spondylolysis. METHODS: Data from 15 patients with pure lumbar spondylolysis or without mild spondylolisthesis, who were treated with U-shape titanium screw-rod fixation system and bone grafting in the Department of Orthopedics of Jinan Military General Hospital from May 2012 to May 2016, were retrospectively reviewed. Operation time, intraoperative blood loss and postoperative drainage were observed. The lumbar spine X-ray, CT, Visual Analogue Scale and Oswestry Disability Index were compared before operation, 3, 6 and 12 months after operation. RESULTS AND CONCLUSION: (1) The operation time was (115.0±18.8) minutes, the intraoperative blood loss was (280.0±84.3) mL, and the postoperative drainage was (61.0±19.6) mL. (2) By Visual Analogue Scale and Oswestry Disability Index during following-up, pain symptoms and function were significantly improved (P < 0.05). (3) No secondary spondylolisthesis, adjacent vertebral degeneration, internal fixation fracture, loosening, infection or nerve injury occurred during the follow-up. (4) All patients had bony union. The healing time range was 6-12 months, with an average of 8.2 months. (5) In summary, U-shape titanium screw-rod fixation system with bone grafting is a good choice for the treatment of pure lumbar spondylolysis.%背景:单纯腰椎峡部裂经保守治疗无效的患者目前多采用节段内骨折内固定联合峡部裂隙植骨的方法,然而这一方法术式多样,尚存在一定争议.目的:探讨"U"形钛棒系统节段内固定联合峡部植骨治疗单纯腰椎峡部裂的临床疗效.方法:对2012年5月至2016年5月解放军济南军区总医院骨创科收治的15例单纯性腰椎峡部裂伴或不伴轻度椎体滑脱患者的临床资料进行回顾性分析,均给予"U"形钛棒系统节段内固定联合峡部植骨治疗.观察患者手术一般情况包括手术时间、术中出血量、术后引流量;比较术前及术后3,6,12个月腰椎正侧位 X射线、CT、目测类比评分及Oswestry功能障碍指数.结果与结论:①患者手术时间为(115.0±18.8) min,术中出血(280.0±84.3) mL,术后引流量(61.0±19.6) mL;②随访目测类比评分和Oswestry功能障碍指数,患者疼痛症状及功能均明显改善(P < 0.05);③术后随访无继发腰椎滑脱及临近椎间盘退变发生,无内固定断裂及松动,无感染、神经损伤等并发症出现;④所有患者均获得骨性融合,愈合时间为6-12个月,平均8.2个月;⑤综上说明,"U"形钛棒系统节段内固定联合峡部植骨是治疗单纯腰椎峡部裂的较好选择.