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使用动态椎弓根系统进行简单的小关节修复:技术说明与病例系列

Simple facet joint repair with dynamic pedicular system: Technical note and case series.

作者信息

Ozer Ali Fahir, Suzer Tuncer, Sasani Mehdi, Oktenoglu Tunc, Cezayirli Phillip, Marandi Hosein Jafari, Erbulut Deniz Ufuk

机构信息

Koc University Medical School, Neurosurgery Department, Istanbul, Turkey.

American Hospital, Neurosurgery Department, Istanbul, Turkey.

出版信息

J Craniovertebr Junction Spine. 2015 Apr-Jun;6(2):65-8. doi: 10.4103/0974-8237.156049.

Abstract

PURPOSE

Facet joints are important anatomical structures for the stability of spine. Surgical or degenerative damage to a facet joint may lead to spinal instability and causes clinical problems. This article explains the importance of facet joints, reviews facet replacement systems, and describes a simple and effective method for facet replacement after surgical removal of facet joints.

MATERIALS AND METHODS

Ten patients were operated with the diagnosis of unilateral nerve root compression secondary to facet degeneration. The hypertrophic facet joints were removed with microsurgical techniques and the roots were decompressed. Then, a unilateral artificial facet joint was created using two hinged screws and a dynamic rod.

RESULTS

The clinical outcome of all the patients was determined good or excellent at second and last follow-up (mean 13.3 months) controls using visual analog scale (VAS) and Oswestry Disability Index (ODI) scores. Radiological evaluations also demonstrated no implant-related complications.

CONCLUSIONS

The authors suggest that, if removal of a facet joint is necessary to decompress the nerve roots, the joint can be replaced by a construct composed of two hinged screws connected by a dynamic rod. This simple system mimics the function of a normal facet joint and is an effective technique for unilateral facet joint replacement.

摘要

目的

小关节是维持脊柱稳定性的重要解剖结构。小关节的手术损伤或退变损伤可能导致脊柱不稳定并引发临床问题。本文阐述了小关节的重要性,综述了小关节置换系统,并描述了一种在手术切除小关节后进行小关节置换的简单有效方法。

材料与方法

对10例诊断为继发于小关节退变的单侧神经根受压患者进行手术。采用显微外科技术切除肥大的小关节并对神经根进行减压。然后,使用两枚铰链螺钉和一根动力棒构建单侧人工小关节。

结果

在第二次及最后一次随访(平均13.3个月)时,采用视觉模拟量表(VAS)和奥斯维辛残疾指数(ODI)评分评估,所有患者的临床结果均为良好或优秀。影像学评估也未显示与植入物相关的并发症。

结论

作者认为,如果为了减压神经根而必须切除小关节,可用由两枚通过动力棒连接的铰链螺钉组成的结构来替代该关节。这个简单的系统模拟了正常小关节的功能,是一种有效的单侧小关节置换技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c74c/4426524/ec5c5aedb397/JCVJS-6-65-g001.jpg

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