Louis R
Service d'Orthopédie-Traumatologie et Chirurgie Vertébrale, Hôpital Hôtel-Dieu, Marseille.
Rev Chir Orthop Reparatrice Appar Mot. 1988;74(6):549-57.
Between 1978 and 1985, 78 reconstructions of the pars interarticularis were performed for painful spondylolysis in which there had been failure to respond to conservative methods and the subjacent disc was not degenerate. Sixty-five patients were reviewed with a follow-up greater than 2 years and a mean of 4.4 years. The concept of pars interarticularis reconstruction can be attributed to Kimura (1968), Buck (1970) and Nicol and Scott (1986). It consists of a posterior approach with freshening of the margins of the defect, the insertion of cancellous chips taken from the spinous processes, resection of the tips of the articular processes above the partes interarticulares and fixation with a butterfly plate and screws which was devised for this purpose. The plate was removed after 6 months. The rate of union after this procedure was 93.5 per cent and rose to 95.7 per cent after a secondary bone graft. Two bilateral non-unions required a lumbosacral arthrodesis. The results were excellent or good as regards pain in 86 per cent of cases. A return to heavy work and intensive sporting activity was possible in 88 per cent of cases. Movement of the lumbosacral spine was reduced by a mean of 41 per cent.
1978年至1985年间，对78例椎弓根峡部裂患者进行了椎弓根间部重建手术，这些患者对保守治疗无效且相邻椎间盘未退变。对65例患者进行了随访，随访时间超过2年，平均为4.4年。椎弓根间部重建的概念可追溯到木村（1968年）、巴克（1970年）以及尼科尔和斯科特（1986年）。该手术采用后路，清理缺损边缘，植入取自棘突的松质骨碎片，切除椎弓根间部上方关节突的尖端，并用为此设计的蝶形钢板和螺钉进行固定。钢板在6个月后取出。该手术后的愈合率为93.5%，二次植骨后升至95.7%。两例双侧不愈合患者需要进行腰骶部融合术。86%的病例疼痛方面结果为优或良。88%的病例能够恢复繁重工作和高强度体育活动。腰骶部脊柱活动平均减少了41%。
