Gardner V O, Armstrong G W
Department of Orthopaedics, College of Medicine, University of California, Irvine.
Spine (Phila Pa 1976). 1990 Jun;15(6):479-84. doi: 10.1097/00007632-199006000-00009.
Reports in the literature have questioned the practice of using Harrington distraction rods spanning unfused spinal segments for internal fixation of the fractured thoracolumbar spine. However, the long-term incidence of facet joint osteoarthritis has not been reported. This is the report on a retrospective analysis of 20 of these patients with an average follow-up period of 8.0 years. Eighty-five percent of the patients received a classification of good to excellent regarding back pain and 90% returned to their preinjury occupation. Of significance, of 75 lumbar facets traversed by rods but not fused, only two were classified as "closed" or autofused. It remains to be seen if some pedicular systems are superior to this technique in trained hands. However, multisegmental instrumentation with unisegmental fusion is possible without obtaining the severe osteoarthritic changes that animal studies have demonstrated.
文献中的报告对使用哈林顿撑开棒跨越未融合的脊柱节段来内固定胸腰椎骨折的做法提出了质疑。然而，小关节骨关节炎的长期发病率尚未见报道。本文是对其中20例患者进行回顾性分析的报告，平均随访时间为8.0年。85%的患者背痛分级为良好至优秀，90%的患者恢复到受伤前的工作岗位。值得注意的是，在75个被棒穿过但未融合的腰椎小关节中，只有两个被归类为“闭合”或自体融合。在经验丰富的医生手中，某些椎弓根系统是否优于该技术还有待观察。然而，进行单节段融合的多节段器械固定是可行的，且不会出现动物研究中所显示的严重骨关节炎改变。
