Vaccaro A R, Garfin S R
Department of Orthopaedic Surgery, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Spine (Phila Pa 1976). 1995 Dec 15;20(24 Suppl):157S-165S.
Literature review.
To illustrate the indications and potential complications of pedicle screw application in the lumbar spine.
Except for the treatment of severe spondylolisthesis (grades 3 and 4) at L5-S1, using autogenous bone graft and with device removal often fusion is obtained. Pedicle screw devices labeled for stabilizing the lumbar spine or correcting deformities in fusion procedures are currently considered Class III medical devices by the Food and Drug Administration, that is, investigational or experimental forms of spinal fixation. Recent clinical studies have attested to their usefulness and safety by qualified surgeons for selected surgical indications.
Literature synthesis.
Segmental fixation increases the fusion rate and clinical success of indicated patients undergoing the procedure in lumbar spine operations, as it does in the treatment of fusion of long bone injuries, scoliosis, and other comparable surgeries.
With this technology, surgeons can effectively reduce the pseudarthrosis rate, improve patient satisfaction and results of functional studies, and ultimately reduce the long-term cost to society as a result of effective initial posterior lumbar spine surgery.
文献综述。
阐述腰椎椎弓根螺钉应用的适应证及潜在并发症。
除了在L5-S1节段治疗重度腰椎滑脱(3度和4度)时采用自体骨移植且常需取出内固定装置外,通常可实现融合。目前,食品药品监督管理局将用于腰椎融合手术中稳定脊柱或矫正畸形的椎弓根螺钉装置视为Ⅲ类医疗器械,即脊柱固定的研究性或实验性形式。近期的临床研究已证实,合格的外科医生在选定的手术适应证中使用这些装置是有用且安全的。
文献综合分析。
节段性固定可提高腰椎手术中接受该手术的适应证患者的融合率及临床成功率,就如同在长骨损伤融合、脊柱侧弯及其他类似手术的治疗中一样。
借助这项技术,外科医生能够有效降低假关节形成率,提高患者满意度及功能研究结果,最终通过有效的初次腰椎后路手术降低社会的长期成本。