Peng Baogan, Li Duanming, Pang Xiaodong
From the Department of Spinal Surgery, Institute of Spinal Surgery, General Hospital of Armed Police Force, Beijing, China.
Medicine (Baltimore). 2015 Jul;94(27):e1127. doi: 10.1097/MD.0000000000001127.
Three-level lumbar spondylolyses are extremely rare. So far, only 11 cases were reported in the literature. Treatment of multilevel spondylolyses has not been consistent. Conservative treatment is commonly considered first in most patients, but those who remain symptomatic may benefit from operative treatment. We report here 3 cases of 3-level lumbar spondylolyses that were treated successfully with direct isthmic repair in 2 cases and a combined surgery of isthmic repair and interbody fusion in 1 case. Our clinical results indicated that direct defect repair using the screw-hook technique is a simple and safe procedure for the motion segment with normal disc. If the involved disc shows degenerative change, fusion surgery should be consideredSurgical treatment of multilevel spondylolyses varies between fusion, direct isthmic repair, and combined management associating 2 procedures at different levels. The success of management of the 3 patients with 3-level spondylolyses depends on the choice of appropriate treatment for every patient.
三级腰椎峡部裂极为罕见。迄今为止，文献中仅报道了11例。多级峡部裂的治疗方法并不一致。大多数患者通常首先考虑保守治疗，但仍有症状的患者可能从手术治疗中获益。我们在此报告3例三级腰椎峡部裂，其中2例通过直接峡部修复成功治疗，1例通过峡部修复与椎间融合联合手术治疗。我们的临床结果表明，对于椎间盘正常的运动节段，使用螺钉钩技术进行直接缺损修复是一种简单且安全的手术。如果受累椎间盘出现退变改变，则应考虑融合手术。多级峡部裂的手术治疗方法包括融合、直接峡部修复以及不同水平两种手术联合的综合治疗。3例三级峡部裂患者治疗的成功取决于为每位患者选择合适的治疗方法。
