节段性内固定方法治疗腰椎峡部裂的临床评价

Clinical Evaluation of Intrasegmental Fixation for Direct Repair of Lumbar Spondylolysis

目的 :探讨腰椎峡部裂节段内固定方法的最佳选择。方法 :应用记忆合金固定器法 10例 ,均为单纯腰椎峡部裂患者 ;Scott钢丝捆绑技术 18例 ,12例为合并椎间盘突出的患者 ;改良Buck螺钉法 8例 ,均为合并椎管狭窄患者。共 3 6例 ,全部病例经临床随访并评定效果。结果 :3 6例经 6个月～ 4年 (平均 18个月 )随访 ,按李稔生的标准 ,优良率 :记忆合金固定器组为 10 0 % ,Scott钢丝捆绑组 93 .7% ,改良Buck螺钉组 87.5 %。总优良率 88.9%。结论 :三种内固定方法可分别适合存在不同合并症的腰椎峡部裂患者。合理选择内固定方法可提高疗效 ,节约手术时间并减少创伤出血。

Objective:To evaluate the best selection of methods for treating lumbar spondylolysis.Methods:Ten patients with lumbar spondylolysis were treated by intrasegmental shape memory alloy fixator(A group).Scott's technique of intrasegmental wire fixation was used to treat 18 patients,12 of them were incorporated with lumbar disc herniation(B group).Eight patients incorporated with lumbar spinal stenosis were treated by Buck's technique of screw fixation(C group).All 36 patients were called back a long time on the schedule to evaluate treatment effect.Results:According to Liniansheng's criterion,that of A,B,C group was 100%,93.7% and 87.5% respectively.The total satisfactory rate was 88.9%.Conclusion:Three ways of intrasegmental fixation can be choosed to treat patients with lumbar spondylolysis incorporated with other symptom.Curative effect can be improved by proper technique.