Head of the Pediatric Traumatological and Orthopedic Unit Federal Center of Traumatology, Orthopedics and Arthroplasty, Ministry of Health of the Russian Federation, 33 Fedor Gladkov St., Cheboksary, Chuvash Republic, 428020, Russia.
Professor, Chief Doctor Federal Center of Traumatology, Orthopedics and Arthroplasty, Ministry of Health of the Russian Federation, 33 Fedor Gladkov St., Cheboksary, Chuvash Republic, 428020, Russia;; Head of the Department of Traumatology, Orthopedics and Extreme Medicine Chuvash State University named after I.N. Ulyanov, 15 Moskovsky Prospect, Cheboksary, Chuvash Republic, 428015, Russia.
Sovrem Tekhnologii Med. 2021;13(5):62-68. doi: 10.17691/stm2021.13.5.08. Epub 2021 Oct 29.
was to assess the effectiveness of the minimally invasive technique used to reconstruct the vertebral arch with a pedicle screw hook system in grade I isthmic spondylolisthesis in comparison with the traditional technique of segment stabilization with interbody fusion.
The study included 26 patients aged from 11 to 17 years. The follow-up period lasted from 1 to 7 years. Two groups were formed: in group 1 (n=6), segments L-S were stabilized using the traditional technique; in group 2 (n=20), the arch of the L vertebra was reconstructed by means of minimally invasive surgery. The pain syndrome was assessed in each study group using the visual analogue scale and Macnab criteria before and after surgery; blood loss, duration of surgery in minutes, and hospitalization in days were also measured.
According to the Macnab scale, the two presented techniques did not show any statistically significant differences; however, when the arch synthesis technique was employed the spinal motion segment remained intact. Furthermore, in group 2, the volume of blood loss was smaller (44.0±19.6 compared to 300.0±130.4 ml, p<0.0001), the duration of the operation was 176.0±41.6 compared to 349.2±93.2 min, p<0.0001, and hospital stay was 6.9±1.6 compared to 10.0±2.1 days, p=0.0025 in the control group.
The technique of vertebral arch reconstruction by a minimally invasive access gives the possibility to stabilize the spinal motion segment and to preserve biomechanics and movements in the spine. This technique allows for shorter inpatient stays for patients as well as earlier recovery and rehabilitation due to reduced surgery time and blood loss.
评估经皮椎弓根钩系统微创技术重建Ⅰ度峡部裂性脊柱滑脱与传统节段稳定融合术治疗的疗效。
研究纳入 26 例 11-17 岁患者，随访时间 1-7 年。分为两组：组 1（n=6）采用传统技术稳定 L-S 节段；组 2（n=20）采用微创技术重建 L 椎体弓。采用视觉模拟评分和 Macnab 标准评估两组患者术前和术后疼痛综合征；测量手术失血量、手术时间和住院时间。
根据 Macnab 评分，两种方法无统计学差异，但采用弓合成技术时脊柱运动节段保持完整。此外，组 2 术中出血量更少（44.0±19.6 比 300.0±130.4ml，p<0.0001），手术时间更短（176.0±41.6 比 349.2±93.2min，p<0.0001），住院时间更短（6.9±1.6 比 10.0±2.1 天，p=0.0025）。
微创入路重建椎弓可稳定脊柱运动节段，保持脊柱生物力学和运动功能。该技术可减少手术时间和出血量，缩短患者住院时间，促进患者早期康复。
