O'Neill D B, Micheli L J
St. John Sports Medicine Center, Naussau Bay, Texas.
Spine (Phila Pa 1976). 1989 Dec;14(12):1342-55. doi: 10.1097/00007632-198912000-00011.
The postoperative radiographs of 48 patients who underwent posterolateral in situ fusion for spondylolysis and Grade 1 or less spondylolisthesis over an 11-year period showed healing of the pars defects in 90% of the cases. The patients who showed healing had an average preoperative duration of symptoms of 17 months (mean, 12 months). The five patients whose radiographs showed persistent defects postoperatively were found to have had preoperative symptoms for an average of 47 months (mean, 48 months). This significantly greater (P 0.05) duration of symptoms prior to stabilization was the only variable that proved to be statistically significant. Controversy continues to exist as to the etiology of spondylolysis; however, the ability to heal the defect with lumbar spinal stability certainly supports the theory that the defect is a result of fatigue stresses, which finally manifest as a fracture seen on radiographs as the spondylolytic defect. Posterior spinal stabilization in those patients with symptoms for a period of less than 2 years who have failed conservative management can be expected to heal the pars defects.
在11年期间，对48例因椎弓根峡部裂和1度及以下椎体滑脱接受后外侧原位融合术的患者进行的术后X线片显示，90%的病例椎弓根缺损愈合。显示愈合的患者术前平均症状持续时间为17个月（平均12个月）。术后X线片显示持续缺损的5例患者术前平均症状持续时间为47个月（平均48个月）。稳定手术前症状持续时间显著更长（P<0.05）是唯一被证明具有统计学意义的变量。关于椎弓根峡部裂的病因仍存在争议；然而，通过腰椎稳定性使缺损愈合的能力肯定支持这样一种理论，即该缺损是疲劳应力的结果，最终表现为在X线片上可见的骨折，即椎弓根峡部裂缺损。对于保守治疗失败且症状持续时间少于2年的患者，后路脊柱稳定术有望使椎弓根缺损愈合。
