椎弓根钉钩系统加峡部植骨系统治疗单纯腰椎峡部不连5年疗效随访

Effect of pedicle screw-lamina hook plus isthmic bone grafting on the lumbar spondylolysis: a 5-year follow-up

目的椎弓根螺钉、椎板钩加峡部植骨术治疗腰椎峡部不连手术5年疗效随访研究。方法 2006-2008,我院收治20例单纯腰椎峡部不连患者采用椎弓根螺钉、椎板钩加峡部植骨固定治疗术后5年随访。结果术前及术后5年随访VAS评分有明显统计学意义(P<0.05);患者术后5年CT断扫峡部裂植骨均骨性愈合。20例患者均未发生脱钩及临近节段退变(椎间隙高度丢失);2例诉腰椎活动度较术前轻度受限;6例出现腰椎间盘退变。结论与多节段固定融合术相比,椎弓根螺钉、椎板钩加峡部植骨术治疗腰椎峡部不连是对腰椎正常生理活动范围干扰小、临近节段退变率低的一种可靠、有效的单椎体动态固定术式。

Objective To observe the effect of pedicle screw-lamina hook plus isthmic bone grafting on the lumbar spondylolysis through a 5-year follow-up study. Methods From 2006 to 2008,20 cases with lumbar spondylolysis who had been treated with the pedicle screw-lamina hook plus isthmic bone grafting were selected in the present study,and the patients were followed up for 5 years. Results The VAS score of postoperative 5 years was significantly different from that pre-operation （P〈0.05）.The bone fusion was observed in all patients after 5-year follow-up. None of them had detachmented the pedicle screw-lamina hook and intervertebral altitude loss. Only 2 cas-es felt lumbar restricted movement. 6 cases had degeneration of lumbar intervertebral disc. Con-clusion Compared with the multi-segmental fixation and interbody fusion,the pedicle screw-lamina hook plus isthmic bone grafting is a single-fixation,and this operation is technically simple and no sacrifices of lumbar motion ranges,and it is proved to be effective.