摘要
目的 :探讨应用Smiley face rod固定系统治疗L5椎弓峡部裂的临床疗效。方法:2016年1月~2017年6月,我科采用Smiley face rod固定系统节段内固定植骨融合治疗腰椎峡部裂患者18例,男13例,女5例,年龄28.2±3.2岁(25~32岁),术前平均病程为16.3±5.7个月(7~24个月)。峡部裂节段均位于L5。术后3个月、1年时进行随访,对患者进行疼痛视觉模拟评分(visual analogue scale,VAS)及Oswestry功能障碍指数(Oswestry disability index,ODI)评定,评价其临床治疗效果。行X线、CT等检查,分析术前和术后L5/S1椎间活动度变化及椎间不稳发生率变化情况,并评价患者术后植骨融合情况。结果:手术时间平均90.0±24.1min,术中出血量平均140±15ml。平均随访18.5±5.0个月(12~24个月)。术前VAS评分为7.3±2.5分,ODI为(67.0±15.1)%;术后3个月时分别为3.0±1.2分和(17.2±4.5)%,较术前明显改善(P<0.05);术后1年时分别为1.0±0.6分和(9.1±5.3)%,较术后3个月时进一步改善(P<0.05)。术前L5/S1间隙活动度为13.1°±2.1°,存在腰椎不稳或小于Ⅰ度滑脱者共15例(83.3%,15/18);术后1年时分别为9.3°±1.6°和2例(11.1%,2/18),两者之间存在统计学差异(P<0.05)。术后1年时随访患者峡部裂均获得骨性愈合。结论 :应用Smiley face rod固定系统治疗L5椎弓峡部裂具有创伤小、对神经干扰少、恢复正常的解剖结构、提高椎间稳定性的优点。
Objectives： To investigate the clinical outcome of Smiley face rod fixation system for lumbar isthmic spondylolysis. Methods： From January 2016 to June 2017, 18 patients with isthmic spondylolysis were treated with smiley face screw-rod fixation system. There were 13 males and 5 females, with an average age of 28.2±3.2（25-32） years old. The average disease duration was 16.3±5.7（7-24） months. L5 isthmic spondylolysis was involved in all cases. All patients had been followed up at 3 months and 1 year after surgery. The preoperative and postoperative visual analogue scale（VAS） and Oswestry disability index（ODI） were compared. The X-ray and CT scan were evaluated to analyze the change of range of motion in the lumber spine and the bony fusion rate. Results： The mean operation time was 90.0±24.1 minutes. The average blood loss was 140±15ml. The average follow-up was 18.5±5.0（12-24） months. The VAS at 3 months after operation was 3.0±1.2, and the ODI was （17.2±4.5）% respectively, which showed significant differences compared with the preoperative ones[7.3±2.5 and （67.0±15.1）%]（P〈0.05）. The VAS and ODI at 1 year after operation were 1.0±0.6 and （9.1±5.3）%, which showed significant differences compared with 3 months postoperation（P〈0.05）. The range of motion between L5 and S1 was 13.1°±2.1° and the incidence of lumbar instability was 83.3%（15/18） preoperatively; it was 9.3°±1.6° and 11.1%（2/18） postoperatively, and there was statistic difference（P〈0.05）. All patients achieved bone fusion in the isthmic defect 1 year after operation. Conclusions： The Smiley face rod fixation is a reliable treatment for lumbar spondylolysis with the advantage of minimal invasive, less nerve interference, and to restore normal anatomical structure, maintain the lumbar spine stability.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
北大核心
2017年第10期878-882,共5页
Chinese Journal of Spine and Spinal Cord
