Niu C C, Chen W J, Chen L H, Shih C H
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China.
Am J Orthop (Belle Mead NJ). 1996 Jun;25(6):418-24.
Posterior transpedicular instrumentation with short segmental fixation represents a current trend in surgery for unstable spinal problems, such as spondylolisthesis. A reduction-fixation spinal system with 5.75- to 6.25-mm diameter pedicle screws of variable angles and an 8-mm diameter rod can achieve a rather rigid, short-segment fixation and satisfactory reduction of spondylolisthetic deformities. In clinical applications, 84% of 85 patients with spinal instability had good-to-excellent results for back pain, 88% for sciatica, and 86% for claudication; 91% achieved solid posterolateral fusion from the roentgenographic studies. This reduction-fixation system achieved a reduction of 71% +/- 5.3% of slipping width in this population. Posterior lumbar interbody fusion is mandatory for effective and lasting reduction. Complications from reduction fixation including pedicle-screw loosening (12%), pedicle screw breakage (7%), adjacent instability (7%), and nerve root injury (2%).
短节段固定的后路经椎弓根器械植入术是治疗腰椎滑脱等不稳定脊柱疾病手术的当前趋势。一种直径为5.75至6.25毫米、角度可变的椎弓根螺钉与直径为8毫米的棒组成的复位固定脊柱系统，可实现相当坚固的短节段固定，并能令人满意地矫正腰椎滑脱畸形。在临床应用中，85例脊柱不稳定患者中，84%的患者背痛症状改善为良至优，88%的坐骨神经痛患者症状改善良好，86%的跛行患者症状改善良好；91%的患者经影像学检查实现了牢固的后外侧融合。该复位固定系统在该人群中使滑脱宽度减少了71%±5.3%。有效的长期复位必须进行后路腰椎椎间融合术。复位固定的并发症包括椎弓根螺钉松动（12%）、椎弓根螺钉断裂（7%）、相邻节段不稳定（7%）和神经根损伤（2%）。
