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一种新型解剖型钩-棒-椎弓根螺钉系统在年轻腰椎峡部裂患者中的应用：一项初步研究。

Application of a new anatomic hook-rod-pedicle screw system in young patients with lumbar spondylolysis: A pilot study.

作者信息

Li Duan-Ming, Li Yong-Chao, Jiang Wei, Peng Bao-Gan

机构信息

Department of Orthopaedics, The Third Medical Center of PLA General Hospital, Beijing 100039, China.

Department of Anesthesiology, The Third Medical Center of PLA General Hospital, Beijing 100039, China.

出版信息

World J Clin Cases. 2022 Jun 16;10(17):5680-5689. doi: 10.12998/wjcc.v10.i17.5680.

DOI:10.12998/wjcc.v10.i17.5680
PMID:35979102
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9258354/
Abstract

BACKGROUND

The pedicle screw-laminar hook system has strong fixation and is conducive to bone graft fusion for lumbar spondylolysis. However, the current pedicle screw-laminar hook fixation system is not specifically designed for lumbar spondylolysis.

AIM

To investigate the clinical effects of a new anatomical hook-rod-pedicle screw system in the treatment of lumbar spondylolysis in young adults.

METHODS

We designed a new anatomic hook-rod-pedicle screw system for young patients with lumbar spondylolysis. The isthmus and the corresponding pedicle screw entry point were exposed through the intermuscular approach. Autogenous iliac bone graft was obtained to bridge the isthmus defect, and then the anatomic hook-rod-pedicle screw system was used to fix the isthmus in 15 young patients.

RESULTS

At 24 mo follow-up, the visual analogue scale score of low back pain decreased from 6.73 ± 0.88 to 0.73 ± 0.59, and the Oswestry disability index score decreased from 58.20 ± 8.99 to 7.87 ± 4.97. Computed tomography showed bilateral isthmic bone healing in 14 cases and unilateral isthmic bone healing in 1 case. Magnetic resonance imaging showed that the lumbar disc signal of diseased segment and adjacent segments had no change compared with that before surgery. The pain visual analogue scale score of the donor site was 0.20 ± 0.41 at the last follow-up. According to the Modified Macnab score, the excellent and good rate was 100%.

CONCLUSION

The application of this new anatomical hook-rod-pedicle screw system to treat young patients with lumbar spondylolysis has the advantages of less trauma, a simple operation and satisfactory clinical effects.

摘要

背景

椎弓根螺钉-椎板钩系统固定牢固，有利于腰椎峡部裂的植骨融合。然而，目前的椎弓根螺钉-椎板钩固定系统并非专门为腰椎峡部裂设计。

目的

探讨一种新型解剖型钩-棒-椎弓根螺钉系统治疗青年成人腰椎峡部裂的临床效果。

方法

我们为青年腰椎峡部裂患者设计了一种新型解剖型钩-棒-椎弓根螺钉系统。经肌间隙入路显露峡部及相应的椎弓根螺钉进针点。取自体髂骨植骨桥接峡部缺损，然后使用解剖型钩-棒-椎弓根螺钉系统固定峡部，共治疗15例青年患者。

结果

随访24个月时，腰痛视觉模拟评分从6.73±0.88降至0.73±0.59，Oswestry功能障碍指数评分从58.20±8.99降至7.87±4.97。CT显示14例双侧峡部骨愈合，1例单侧峡部骨愈合。MRI显示病变节段及相邻节段腰椎间盘信号与术前相比无变化。末次随访时供区疼痛视觉模拟评分为0.20±0.41。根据改良Macnab评分，优良率为100%。

结论

应用这种新型解剖型钩-棒-椎弓根螺钉系统治疗青年腰椎峡部裂患者具有创伤小、操作简单、临床效果满意等优点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6993/9258354/e5d28e0409d9/WJCC-10-5680-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6993/9258354/dcfbb7b0ab71/WJCC-10-5680-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6993/9258354/bf2864ce4276/WJCC-10-5680-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6993/9258354/c03e2fd9c9e1/WJCC-10-5680-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6993/9258354/c29ccc0291ef/WJCC-10-5680-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6993/9258354/e5d28e0409d9/WJCC-10-5680-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6993/9258354/dcfbb7b0ab71/WJCC-10-5680-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6993/9258354/bf2864ce4276/WJCC-10-5680-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6993/9258354/c03e2fd9c9e1/WJCC-10-5680-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6993/9258354/c29ccc0291ef/WJCC-10-5680-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6993/9258354/e5d28e0409d9/WJCC-10-5680-g005.jpg

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