Noack W, Raetzel G
Orthopädische Klinik und Querschnittgelähmtenzentrum im RKU, Forschungs- und Lehrbereich der Universität Ulm.
Z Orthop Ihre Grenzgeb. 1988 Mar-Apr;126(2):205-10. doi: 10.1055/s-2008-1044894.
Fourteen patients with spondylolisthesis were operated in the Orthopaedic Clinic of Ulm (RKU) from October 1984 to December 1986. All patients suffered from low back pain, 13 had symptomes of nerve root compression, 6 had intermittent spinal claudication. All patients were treated by segmental distraction, reduction of the slipped vertebra and a ventral interbody fusion. The operative technique required first the dorsal approach for distraction and reduction using the fixateur interne (Dick) as well as a self developed special instrument for the reduction of the vertebra (repositeur). The ventral interbody fusion was performed in a one-stage procedure. The self developed special instrument (repositeur) is described and its construction principals, mechanics and its applications. Distraction and reduction of spondylolisthesis was achieved totally or nearly complete with this instrument in all but one patient. In one case the transpedicular screw ripped out. Always the foramina intervertebralia were opened to physiological width. Pain and neurological symptomes completely disappeared in all patients and no additional spinal operation was necessary. No infection and no pseudarthrosis did occur. Our clinical results are discussed in regard to other publications. Operative treatment of spondylolisthesis using the fixateur interne and a new developed special instrument for reduction.
1984年10月至1986年12月期间，乌尔姆骨科诊所（RKU）对14例腰椎滑脱患者进行了手术。所有患者均患有腰痛，13例有神经根受压症状，6例有间歇性跛行。所有患者均接受节段性撑开、滑脱椎体复位及前路椎间融合治疗。手术技术首先需要采用后路入路，使用内固定器（Dick）进行撑开和复位，以及一种自行研制的用于椎体复位的特殊器械（复位器）。前路椎间融合采用一期手术。文中描述了自行研制的特殊器械（复位器）及其构造原理、力学性能和应用。除1例患者外，使用该器械在所有患者中均实现了腰椎滑脱的完全或几乎完全撑开和复位。有1例椎弓根螺钉拔出。始终将椎间孔扩大至生理宽度。所有患者的疼痛和神经症状完全消失，无需再次进行脊柱手术。未发生感染和假关节形成。我们结合其他文献讨论了临床结果。使用内固定器和一种新研制的用于复位的特殊器械对腰椎滑脱进行手术治疗。
