Pu Xiaobing, Yang Shuangshi, Cao Haiquan, Jing Xingquan, Yin Jun
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2014 Mar;28(3):354-7.
To investigate the effectiveness of U-shape titanium screw-rod fixation system with bone autografting for lumbar spondylolysis of young adults.
Between January 2008 and December 2011, 32 patients with lumbar spondylolysis underwent U-shape titanium screw-rod fixation system with bone autografting. All patients were male with an average age of 22 years (range, 19-32 years). The disease duration ranged from 3 to 24 months (mean, 14 months). L3 was involved in spondylolysis in 2 cases, L4 in 10 cases, and L5 in 20 cases. The preoperative visual analogue scale (VAS) and Oswestry disability index (ODI) scores were 8.0 +/- 1.1 and 75.3 +/- 11.2, respectively.
The operation time was 80-120 minutes (mean, 85 minutes), and the blood loss was 150-250 mL (mean, 210 mL). Primary healing of incision was obtained in all patients without complications of infection and nerve symptom. Thirty-two patients were followed up 12-24 months (mean, 14 months). Low back pain was significantly alleviated after operation. The VAS and ODI scores at 3 months after operation were 1.0 +/- 0.5 and 17.6 +/- 3.4, respectively, showing significant differences when compared with preoperative ones (t = 30.523, P = 0.000; t = 45.312, P = 0.000). X-ray films and CT showed bone fusion in the area of isthmus defects, with the bone fusion time of 6-12 months (mean, 9 months). During follow-up, no secondary lumbar spondyloly, adjacent segment degeneration, or loosening or breaking of internal fixator was found.
The U-shape titanium screw-rod fixation system with bone autografting is a reliable treatment for lumbar spondylolysis of young adults because of a high fusion rate, minimal invasive, and maximum retention of lumbar range of motion.
探讨U形钛棒螺钉内固定系统联合自体骨移植治疗青年腰椎峡部裂的疗效。
2008年1月至2011年12月，32例腰椎峡部裂患者接受U形钛棒螺钉内固定系统联合自体骨移植治疗。所有患者均为男性，平均年龄22岁（19 - 32岁）。病程3至24个月（平均14个月）。峡部裂累及L3 2例，L4 10例，L5 20例。术前视觉模拟评分（VAS）和Oswestry功能障碍指数（ODI）分别为8.0±1.1和75.3±11.2。
手术时间80 - 120分钟（平均85分钟），出血量150 - 250毫升（平均210毫升）。所有患者切口均一期愈合，无感染及神经症状等并发症。32例患者随访12 - 24个月（平均14个月）。术后腰痛明显缓解。术后3个月VAS和ODI评分分别为1.0±0.5和17.6±3.4，与术前相比差异有统计学意义（t = 30.523，P = 0.000；t = 45.312，P = 0.000）。X线片及CT显示峡部缺损区骨融合，骨融合时间6 - 12个月（平均9个月）。随访期间未发现继发性腰椎峡部裂、相邻节段退变或内固定松动、断裂。
U形钛棒螺钉内固定系统联合自体骨移植治疗青年腰椎峡部裂具有融合率高、创伤小、能最大程度保留腰椎活动度等优点，是一种可靠的治疗方法。
