峡部植骨修补联合临时单节段钉棒固定治疗青少年腰椎峡部裂

发布时间：2018-02-28 17:14

本文关键词： 青少年峡部裂单节段临时固定峡部修补骨科植入物脊柱植入物单节段固定临时固定椎弓根钉棒固定系统非融合国家自然科学基金　出处：《中国组织工程研究》2017年11期 　论文类型：期刊论文

【摘要】：背景:腰椎峡部裂是引起青少年腰痛的常见原因,保守治疗无效时多采用内固定治疗,方式多种多样,目的是消除疼痛,达到峡部充分的骨性融合。目的:观察峡部植骨修补联合椎弓根钉棒系统临时单节段固定治疗青少年腰椎峡部裂的临床效果。方法:应用峡部植骨修补联合椎弓根钉棒系统临时单节段固定治疗青少年腰椎峡部裂症患者32例,所有患者双侧峡部断裂,其中无滑脱型20例,Ⅰ度滑脱12例。内固定前行腰椎X射线、CT及MRI检查,内固定前及内固定后行目测类比评分及Oswestry功能障碍指数评分观察患者疼痛改善情况,采用MacN ab评价疗效。内固定后随访行腰椎CT检查观察患者峡部植骨愈合情况。骨愈合后行内固定取出,观察患者固定节段的活动度及相邻节段椎间盘退变情况。结果与结论:(1)所有患者均获得峡部骨性愈合,平均愈合时间为7.4个月;(2)所有患者腰痛目测类比评分和Oswestry功能障碍指数评分较内固定前明显改善(P0.05)。(3)取出内固定后,观察发现临时固定节段的腰椎活动度保留,MRI检查示固定节段的相邻椎间盘信号均较内固定前无明显改变;(4)结果说明,峡部修补单节段椎弓根钉棒临时固定可有效治疗青少年腰椎峡部裂,峡部骨性愈合确切,临时固定可有效避免临近节段椎间盘退变产生。
[Abstract]:Background: lumbar spondylolysis is a common cause of adolescent back pain, the use of internal fixation for the treatment of conservative treatment is invalid, a variety of ways, the purpose is to eliminate pain, achieve full isthmic bony fusion. Objective: To observe the clinical effect of bone graft isthmus repair with pedicle screw rod system temporary single segmental fixation in treatment of adolescent lumbar spondylolysis methods: application of bone graft repair combined with pedicle screw rod system temporary single segment fixation for treatment of juvenile lumbar spondylolysis in 32 cases of patients, all patients with bilateral spondylolysis, spondylolisthesis including type 20 cases, 12 cases of spondylolisthesis. Internal fixation on lumbar X ray, CT and MRI examination, and internal fixation before fixed by visual analogue scale and Oswestry disability index scores were observed in patients with pain improvement, the curative effect of MacN AB evaluation. Internal fixation were followed up for lumbar CT examination were observed in patients with bone graft Healing. Bone healing after internal fixation, degeneration activity and adjacent intervertebral disc were observed in patients with segmental fixation. Results and conclusion: (1) all patients obtained isthmus bone healing, the average healing time was 7.4 months; (2) all the patients with low back pain visual analogy score and Oswestry disability index the score improved significantly compared with internal fixation (P0.05). (3) removed after internal fixation, observed temporary fixed segmental lumbar activity retention, MRI showed the fixed segment adjacent intervertebral discs were fixed in no obvious change; (4) the results show that the single segmental pedicle screw repair isthmus bar temporary fixation is effective in the treatment of lumbar spondylolysis, isthmus bone healing is exact, temporary fixation can effectively avoid the adjacent degenerative intervertebral disc segments.

【作者单位】：西安交通大学医学院附属红会医院脊柱外科;西安交通大学医学院附属红会医院骨科;
【基金】：国家自然科学基金资助项目(81301604)~~
【分类号】：R687.3

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