异种皮质骨内固定器治疗退行性腰椎不稳症及腰椎间盘突出症的初步报道

Heterogeneous Compact Internal Fixers for Treatment of Lumbar Spondylolisthesis and Unstable Lumbar Spine

目的探讨异种皮质骨内固定器治疗退行性腰椎不稳症及腰椎间盘突出症的治疗方法。方法对退行性腰椎不稳症12例,腰椎间盘突出症9例,采用手术植入异种皮质骨内固定器32个,其中1个间隙植入2个6例,植入1个12例,2个间隙各植入2个1例,2个间隙各植入1个2例,其中19例加椎弓根钉内固定。结果所有患者术后临床症状消失,无椎间隙感染和排斥反应。摄X线检查示患者手术撑开后的椎间隙高度恢复。结论异种皮质骨内固定器具有足够的支撑、抗滑、维持或增加椎间隙高度的功能,可避免取髂骨和金属椎间融合器植入的一些并发症,是一种防止和治疗腰椎不稳的新方法。

Objective To report the heterogenous compact interal fixers （HCIF） for treatment of lumbar intervertebral disc herniation and unstable lumbar spine. Methods Twelve patients had unstable degenerative lumbar spine and 9 had lumbar intervertebral disc herniation. Twenty- one patients were treated with 32 HCIF, one space implanted with two HCIF in 6 intervertebral spaces and one HCIF in 12 intervertebral spaces. Two patients were implanted with one HCIF in two intervertehral spaces and one patient was implanted with two HCIF in two intervertebral spaces. All of them were treated simultaneously by internal fixation. Results At an average of 4 months fellow-up for HCIF, eight patients had excellent results, eleven good and one fair in clinical evaluation. All segments were confirmed to be solidly fixed by constant X- ray examination at 1- 3 months after operation. There were no break of HCIF, pedicle screw breakage and infection. Conclusion HCIF could provide enough support and anti - slide function. Some complications caused by implanting auto iliac crest and metal cage can be avoided. It is an ideal fusion material and new method in treatment of unstable lumbar spine.