经峡部内固定植骨治疗腰椎峡部不连

Direct repair of the defect and bone grafting with internal fixation in the treatment of lumbar spondylolysis

本文介绍一种手术治疗腰椎峡部不连和轻度滑脱的新方法。手术直接在峡部缺损处修整植骨，并采用通过峡部缺损间隙的加压螺钉和环绕双侧横突基底部至棘突下缘的节段性横突钢丝作内固定，以期使峡部缺损处达到骨性愈合，恢复椎弓的连续性。临床应用本方法治疗腰椎峡部不连和轻度滑脱１７例，均获近期（术后７～２５个月）的随访。Ｘ线复查示植骨愈合１６例，骨性愈合率９４％。按Ｈｅｎｄｅｒｓｏｎ标准评价，临床优良率达９４％。

A new technique for surgical treatment of the spondylolysis or mild spondylolisthesis was introduced. The operation is composed of direct repair of the defect of the pars interarticularis and bone grafting and internal fixation. The fixation was combined wih lagscrew and transverse wire. The screw is crossed the defect within two conical layer of lamina and the wire was encircled the base site of transverse and the inferior edge of spine. The surgical aim is to restore the continuity of the neural arch. In this series, 17 patients have been treated. All patients have a follwn-up of 7 - 25 months, Roentgenologic reexamination showed the presence of trabeculation of bone across the pars defect in 16 cases. Base on Henderson's standard, the rate of clinical satisfaction is 94%.