单钉-柱翼钢板的研制与临床应用

THE DEVELOPNENT AND CLINICAL APPLICATION OF MONONAIL COLUMNWING STEEL PLATE

为简化经椎弓根内固定治疗腰椎滑脱症的手术方法，获得良好的复位固定效果，自行设计了单钉柱翼钢板，改进了Ⅰ式和Ⅱ式手术方法，并采用应力滑移率这一新概念预估术中复位程度。结果所治３４例患者经１年以上随访，按Ｓｔｅｆｅｅ法评定，优２４例，占７０．５％；良９例，占２６．５％。认为，单钉柱翼钢板的设计符合脊柱腰骶部的解剖特点。生物力学、疲劳特性试验及临床应用表明，这种能使柱翼与钢板为一体的骶骨椎弓根固定法，器械自身干扰小，连接处应力分散，手术操作简便，可最大限度地复位，固定可靠。

In order to simplify the operative technique of transvertebral arch root internal fixation for lumbar spondylolisthesis (LSL) and to improve the results of reduction and fixation, the authors designed mononail columnwing steel plate for LSL, modified the operative technique of type Ⅰ and type Ⅱ operations and used a new concept “stress slip rate” to estimate the intra operative redution. According to Steffees criteria for therapeutic effect evaluation, the treatment results of 34 cases followed up for over one year were excellent in 24 cases (70.5 %) and good in 9 (26.5 %). It was believed that the design of the plate accorded with the anatomic characteristics of the lumbosacral spine. The fatigue and biomechanical tests and the clinical application indicated that the mononail columnwing steel plate used for the transvertebro arch root fixation has little self disturbance, disperses the stress in jointed site, and simplifies operation and achieves the maximum redution and reliable fixation.