Yang Xiu, Lin Shun, Chen Han-Lin, Liang Jie, Chen Qing-Quan, Xiao Jie, Chen Jin-Shui
Spinal Ward, The 900th Hospital of Joint Logistic Support Force, PLA, 156 Xierhuan Northern Road, FuZhou, 350025, China.
Spinal Ward, Fuzong Clinical Medical College of Fujian Medical University, FuZhou, China.
J Orthop Surg Res. 2024 Dec 23;19(1):868. doi: 10.1186/s13018-024-05382-8.
There is currently no consensus on the surgical treatment of lumbar spondylolysis in young adults, and the nonunion rate remains relatively high even after surgery. Therefore, in this study, we proposed a modified intravertebral screw-rod fixation technique within a single vertebral segment and investigated the clinical efficacy of this modified fixation system combined with autologous cancellous bone grafting in the treatment of lumbar spondylolysis in young adults.
This study included 28 young adults with lumbar spondylolysis who were treated at our center between 2021 and 2023. All patients underwent modified intravertebral screw-rod fixation within a single vertebral segment combined with autologous cancellous bone grafting. We performed postoperative follow-ups regularly to assess the patient's pain status using the visual analog scale (VAS), Oswestry Disability Index (ODI), and radiological findings.
All 28 patients successfully underwent the surgery with an average operation time and blood loss volume of 96.01 ± 21.3 min and 186.78 ± 63.43 mL, respectively. Postoperatively, patients experienced significant symptom relief, with notable decreases in VAS scores and ODI indices at 1, 3, 6, and 12 months compared with preoperative conditions. These differences were statistically significant (P < 0.05). Radiological findings revealed a healing rate of 92.86% for the 56 fractured pars interarticularis among the 28 patients. No implant-related complications, such as fracture, loosening, or pseudarthrosis, were observed.
The modified intravertebral screw-rod fixation system within a single vertebral segment combined with autologous cancellous bone grafting is a safe and effective treatment for lumbar spondylolysis in young adults. It significantly improves pain and functional disability as it promotes bone healing.
目前，对于年轻成人腰椎峡部裂的手术治疗尚无共识，即使手术后不愈合率仍相对较高。因此，在本研究中，我们提出了一种单节段椎体内螺钉-棒固定技术的改良方法，并研究了这种改良固定系统联合自体松质骨移植治疗年轻成人腰椎峡部裂的临床疗效。
本研究纳入了2021年至2023年在本中心接受治疗的28例年轻成人腰椎峡部裂患者。所有患者均接受了单节段椎体内螺钉-棒改良固定联合自体松质骨移植。我们定期进行术后随访，使用视觉模拟量表（VAS）、Oswestry功能障碍指数（ODI）和影像学检查结果来评估患者的疼痛状况。
28例患者均成功接受了手术，平均手术时间和失血量分别为96.01±21.3分钟和186.78±63.43毫升。术后，患者症状明显缓解，与术前相比，在1、3、6和12个月时VAS评分和ODI指数显著降低。这些差异具有统计学意义（P<0.05）。影像学检查结果显示，28例患者中56个关节突间部骨折的愈合率为92.86%。未观察到与植入物相关的并发症，如骨折、松动或假关节形成。
单节段椎体内螺钉-棒改良固定系统联合自体松质骨移植是治疗年轻成人腰椎峡部裂的一种安全有效的方法。它能显著改善疼痛和功能障碍，促进骨愈合。
