Jeanneret B, Jovanovic M, Magerl F
Klinik für Orthopädische Chirurgie, Kantonsspital, St. Gallen, Switzerland.
Clin Orthop Relat Res. 1994 Jul(304):130-8.
Diagnostic external fixation was performed in 101 patients with disabling low back pain. In 47 patients, pain was relieved by stabilization but returned after destabilization. These patients were considered good candidates for a fusion operation. Results after fusion are available for 34 patients: 14 (41%) patients had a good, 12 (35%) had a fair, and 8 (14%) had a bad result. In two patients, pain was relieved by stabilization and did not return after fixator removal; no fusion operation was performed. Fifty-two patients did not respond positively to external fixation. Nine were operated on despite negative results with fixation. Of these, seven patients had a bad result, one a good result (however, this patient had spinal stenosis and the indication for external fixation was wrong), and, in one, the follow-up time is too short. Positive results with external skeletal fixation may predict a successful fusion operation with reasonable accuracy. If stabilization does not relieve the patient's pain, spinal fusion is unlikely to be of any benefit.
对101例伴有严重腰痛的患者实施了诊断性外固定术。47例患者的疼痛通过固定得到缓解，但在去除固定后又复发。这些患者被认为是融合手术的良好候选者。34例患者融合术后的结果如下：14例（41%）效果良好，12例（35%）效果尚可，8例（14%）效果不佳。2例患者经固定后疼痛缓解，去除固定器后未复发；未进行融合手术。52例患者对外固定术未产生积极反应。尽管固定结果为阴性，但仍有9例接受了手术。其中，7例患者效果不佳，1例效果良好（然而，该患者患有椎管狭窄，外固定的指征有误），1例患者的随访时间过短。外骨骼固定的阳性结果可能以合理的准确性预测融合手术的成功。如果固定不能缓解患者的疼痛，脊柱融合术不太可能带来任何益处。
