腰椎崩裂滑脱单节段复位固定系统的研究及其临床应用

The direct repair of the defect and grafting with singlesegment reduction fixation system in the treatment ofIumbar spondylolysis and spondylolisthesis

作者以国人４６具干燥骨标本椎弓的测量结果为依据，自行设计了腰椎崩裂滑脱单节段复位固定系统（ＬＳＲＦ）。生物力学测试结果表明：ＬＳＲＦ固定强度为Ｈｅｆｔｉ钩螺钉的１／６倍（Ｐ＜０．０５），Ｓａｌｉｂ弓根螺钉棘突钢丝的２．７倍。ＬＳＲＦ以椎板钩和椎板接触点为支点，通过杠杆及椎弓根螺钉提拉作用，使滑椎复位。临床应用１８例，术前椎体滑移２６．６７％，滑脱间盘高度１４．９４ｍｍ；术后滑移３．３８％，间盘高度１７．０８ｍｍ。１５例平均随访１２个月，按Ｈｅｎｄｅｒｓｏｎ标准评定，优１３例，良１例，可１例。提示ＬＳＲＦ既有良好复位又坚强固定作用，为椎弓崩裂滑脱治疗增添了新的方法。

AbstractWe designed lumbar spondylolysis and spondy-lolisthesis single segment reduction fixation system ac-cording to neural arch measured in the 46 dried speci-men. The biomechanical tests showed that its strength-is 1.6 times that of Hefti′s technique,2. 7 times that ofSalib′ s technique. It used contacted point of lamina by-lamina hook as fulcrum, through lever and pediclescrew to pull back olisthetic vertebrae. 18 patients weretreated with this method. The displacement rate was26. 67%before operation and 3. 38%after operation.The height of disc was 14. 94mm before operation and17. 08mm after operation. 15 patients were followed upfor 12 months. By Henderson standard,excellent resultwas moted in 13 patients, good in 1 and fair in 1. Weconclude that LSRF has good reduction and rigid fixa-tion and it is a new technique for lumbar spondylolysisand spondylolisthesis.