Department of Neurosurgery, Kanuni Sultan Süleyman Education and Research Hospital, University of Health Sciences, Istanbul, Turkey.
World Neurosurg. 2021 Feb;146:e1301-e1306. doi: 10.1016/j.wneu.2020.11.165. Epub 2020 Dec 8.
Spondylolysis refers to a defect of the vertebral pars interarticularis. Percutaneous direct pars repair using a minimally invasive technique was performed in a group of young patients to maintain their spinal segment movement and to restore their normal anatomy. The aim of this study was to present the clinical, functional, and radiologic outcomes of pars defects that were repaired percutaneously via the minimally invasive technique.
This was a single-center, nonrandomized, prospective study of the demographic, clinical, functional, and radiographic outcomes of 18 patients (age range, 18-32 years). The visual analog scale for back pain and the Oswestry Disability Index were used to evaluate the functional outcomes. The Macnab criteria were applied to evaluate patient satisfaction after surgery.
All patients were admitted with bilateral pars fracture at the level of L4 (n = 4) or L5 (n = 14). The average duration of clinical follow-up was 16.04 months (range, 12-28 months). With reference to the Macnab criteria, 17 patients (94%) showed perfect or good outcomes. Fusion or bridging of bones was observed on computed tomography in 14 patients (77%) at the last radiological examination.
Minimally invasive surgery to treat symptomatic spondylolysis is a safe option that minimizes muscle and soft tissue dissection. In this study, good clinical and functional outcomes were achieved in young patients with low complications and high fusion rates using completely percutaneous treatment.
脊椎峡部裂是指椎弓峡部的缺损。通过微创技术对年轻患者进行经皮直接峡部修复，以保持脊柱节段的运动并恢复其正常解剖结构。本研究旨在介绍通过微创技术经皮修复峡部缺损的临床、功能和影像学结果。
这是一项单中心、非随机、前瞻性研究，共纳入 18 例（年龄 18-32 岁）患者的人口统计学、临床、功能和影像学结果。采用视觉模拟评分法（VAS）评估腰痛，采用 Oswestry 功能障碍指数（ODI）评估功能结果。采用 Macnab 标准评估术后患者满意度。
所有患者均因双侧 L4（n=4）或 L5（n=14）峡部骨折入院。平均临床随访时间为 16.04 个月（范围 12-28 个月）。根据 Macnab 标准，17 例患者（94%）表现出完美或良好的结果。14 例患者（77%）在最后一次影像学检查时 CT 显示骨融合或桥接。
微创治疗有症状的脊椎峡部裂是一种安全的选择，可最大限度地减少肌肉和软组织的解剖。在这项研究中，使用完全经皮治疗的年轻患者并发症低、融合率高，取得了良好的临床和功能结果。
