新型脊柱内固定器治疗腰椎滑移

Application of new-designed internal fixator in treatment of Spondylolithesis

目的探讨自行设计腰椎滑移内固定器(池氏钉)的生物力学特性及临床应用效果。方法比较3种的脊柱内固定器的抗拔出力及抗旋转力,并应用自制脊柱内固定器治疗腰椎滑移48例。结果生物力学试验表明,固定螺钉AF-II型与RF-II型及池氏钉-II型拔出力无显著差别,而提拉螺钉AF-II型比RF-II型及池氏钉-II型差。在旋转实验中,池氏钉-II型较AF-II型与RF-II型强,而与正常腰椎相比无明显差异(P<0.05)。临床应用48例,复位率达95.8%。随访10～52月,优良率达97.9%。结论池氏钉是一种较为理想的腰椎滑移复位固定器;I度滑移,不需刻意复位;术后适当减少腰椎活动,以利于椎体融合并防止内固定器械的断裂。

Objective To explore the biomechanical charateristics and clinical result of new-designed internal fixator for spondylolithesis. Methods The strength against pulling out and against rotaion werecomparied with each other in the three kinds of spinal internal fixators, and the new-designed fixator was applicated in forty-eight caese of lumbar spondylolithesis. Results The mechanical studies showes no statistic difference with anti-pull-out power of fixation screws but significant difference of lift screws and anti-rotation power of three kinds of fixator. With a period of 10 to 52 months' follow-up, the reduction rate and satisfactory rate were 95.8% and 97.9% respectively. Conclusion The new-designed fixator is a kind of satisfactory instrument for spondylolithesis. No reduction was needed for I degree spondylolithesis. Reduction of motion of lumbar vertebrae after the operation is benefit to prevent from the breakage of internal fixators.