峡部植骨联合短期钉棒固定治疗腰椎峡部裂的临床效果

Abstract
Figure/Table
References
Related Citation (15)

Download: PDF (1003 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To observe and analyze the clinical effect of isthmus bone grafting combined with short-term nail and rod fixation in the treatment of lumbar spondylolysis. Methods Basic data of 173 patients with lumbar spondylolysis admitted to the Department of Spinal Surgery of Guangxi Autonomous Regional Corps Hospital of Chinese People’ s Armed Police Force from January 2010 to December 2022 were analyzed retrospectively. According to the treatment methods, the patients were divided into reference group (isthmus bone graft +U-shaped titanium rod fixation, n=55) and study group (isthmus bone graft+short-term nail and rod fixation, n=118), and the operation completion, pain and lumbar function, lumbar disc degeneration and isthmus bone healing were compared. Result There was no statistical difference in sex, age, operation time or intraoperative blood loss between the two groups (P＞0.05).The isthmus healing time in the study group [(10.65±0.68) months] was shorter than that in the reference group [(13.40±1.16) months], and the hospitalization time in the study group [(14.43±2.32) d] was shorter than that in the reference group [(16.51±2.81) d], with statistical significance (P＜0.05). After operation, the scores of VAS and ODI in the two groups decreased significantly, but there was no statistical value (P＞0.05). The rate of isthmus nonunion in the study group was 6.78%, which was lower than that in the reference group (20.34%), and the difference was statistically significant (χ²=8.298,P＜0.05). The degeneration rate of adjacent intervertebral disc in the study group was 2.54%, which was slightly lower than that in the reference group (5.45%), and the difference was not statistically significant (P＞0.05). Conclusions For patients with lumbar spondylolysis, isthmus bone grafting combined with short-term nail and rod fixation can effectively relieve patients’ pain and lumbar dysfunction, showing a good isthmus bone fusion effect. At the same time, temporary fixation devices can be taken out after isthmus healing, which minimizes the risk of degeneration of adjacent intervertebral discs.

Key words： isthmus bone grafting short-term nail and rod fixation lumbar spondylolysis clinical efficacy

Received: 17 August 2023

ZTFLH:

R687.3

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	LEI Ming
	WEI Xinhui
	YE Qing
	LAN Yuxin
	LIU Tangyu
	SU Chang
	HUANG Xiaodan

Cite this article:

LEI Ming,WEI Xinhui,YE Qing等. Analysis of curative effect of isthmus bone grafting combined with short-term nail and rod fixation in treatment of lumbar spondylolysis[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(3): 214-217.

URL:

http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2024/V35/I3/214

[7]	陈勇喜,覃海飚,农必华,等.镜下植骨椎弓根钉固定治疗腰椎峡部裂[J].中国矫形外科杂志,2021,29(10):933-935.
[1]	朱玲新,杨海涵,王云阁.透视引导下小关节注射治疗症状性腰椎峡部裂的疗效和预后因素分析[J].颈腰痛杂志,2023,44(2):250-252.
[8]	黄云飞,刘继军,郭磊,等.采用临时短节段椎弓根螺钉固定联合髂骨植骨治疗青少年腰椎椎弓崩裂症的临床观察[J].骨科临床与研究杂志,2021,6(1):13-19.
[2]	蓝云,张建政,孙天胜.腰椎后路峡部植骨钉棒系统固定治疗青年腰椎双侧峡部裂疗效分析[J].中国脊柱脊髓杂志,2019,29(8):712-716.
[9]	程刚,杨小玲,魏思奇.单纯腰椎峡部裂的治疗进展[J].医学综述,2022,28(5):980-984.
[3]	Choi J H, Ochoa J K, Lubinus A, et al. Management of lumbar spondylolysis in the adolescent athlete: a review of over 200 cases[J]. Spine J, 2022, 22(10):1628-1633.
[10]	Ye Y, Jin S, Zou Y, et al. Biomechanical evaluation of lumbar spondylolysis repair with various xation options: a nite element analysis[J]. Front Bioeng Biotechnol, 2022, 10: 1024159.
[4]	Muthiah N, Ozpinar A, Eubanks J, et al. Direct pars repair with cannulated screws in adults: a case series and systematic literature review[J].World Neurosurgery, 2022,163:E263- E274.
[11]	Li L, Jiang S, Zhao J, et al. Comparison of two internal fixation systems in lumbar spondylolysis by finite element methods[J]. Comput Methods Programs Biomed, 2022, 218: 106713.
[5]	汪大伟,王华东,李利,等.两种内固定系统治疗腰椎峡部裂伴轻度滑脱的疗效分析[J].中国脊柱脊髓杂志,2022,32(10):911-918.
[12]	Goetzinger S, Courtney S, Yee K, et al. Spondylolysis in young athletes: an overview emphasizing nonoperative management[J]. J Sports Med (Hindawi Publ Corp), 2020: 9235958.
[6]	金新蒙,周文超,徐波,等.峡部螺钉联合非融合椎弓钉固定腰椎峡部裂[J].中国矫形外科杂志,2022,30(19):1802-1805.
[13]	程刚,杨小玲,魏思奇.单纯腰椎峡部裂的治疗进展[J].医学综述,2022,28(5):980-984.
[7]	陈勇喜,覃海飚,农必华,等.镜下植骨椎弓根钉固定治疗腰椎峡部裂[J].中国矫形外科杂志,2021,29(10):933-935.
[14]	沈彬,潘福敏,周宁峰,等.节段内修复手术治疗腰椎峡部裂及轻度峡部裂性滑脱的疗效分析[J]. 颈腰痛杂志, 2016, 37(5):361-364.
[8]	黄云飞,刘继军,郭磊,等.采用临时短节段椎弓根螺钉固定联合髂骨植骨治疗青少年腰椎椎弓崩裂症的临床观察[J].骨科临床与研究杂志,2021,6(1):13-19.
[15]	石学文,张涛,甄平,等.青少年腰椎峡部裂的致病因素及治疗进展[J].中国矫形外科杂志,2021,29(1):60-63.
[9]	程刚,杨小玲,魏思奇.单纯腰椎峡部裂的治疗进展[J].医学综述,2022,28(5):980-984.
[16]	陈峰,滕乐群,秦永超,等.单纯腰椎峡部裂的治疗进展[J].中华骨与关节外科杂志,2019,12(10):816-820.
[10]	Ye Y, Jin S, Zou Y, et al. Biomechanical evaluation of lumbar spondylolysis repair with various xation options: a nite element analysis[J]. Front Bioeng Biotechnol, 2022, 10: 1024159.
[17]	张涛,屈涛,刘华,等.Wiltse入路椎弓根钉-椎板钩内固定联合自体髂骨移植修复单节段腰椎峡部裂疗效分析[J].解放军医学杂志,2020,45(7):761-766.
[11]	Li L, Jiang S, Zhao J, et al. Comparison of two internal fixation systems in lumbar spondylolysis by finite element methods[J]. Comput Methods Programs Biomed, 2022, 218: 106713.
[18]	闫鹏,刘金辉,崔京福,等.钉棒系统固定结合峡部植骨融合治疗青少年腰椎峡部裂远期疗效[J].中国骨伤,2019,32(12):1156-1159.
[12]	Goetzinger S, Courtney S, Yee K, et al. Spondylolysis in young athletes: an overview emphasizing nonoperative management[J]. J Sports Med (Hindawi Publ Corp), 2020: 9235958.
[19]	蔡芝军,何晓清,浦路桥,等.双侧腰椎峡部裂钉-钩-棒固定联合植骨术[J].中国矫形外科杂志,2021,29(23):2186-2189.
[13]	程刚,杨小玲,魏思奇.单纯腰椎峡部裂的治疗进展[J].医学综述,2022,28(5):980-984.
[20]	陈德元,刘永恒,黄福立.椎弓根钉棒系统内固定结合自体髂骨植骨治疗青年腰椎峡部裂[J].中国骨与关节损伤杂志,2021,36(5): 491-493.
[14]	沈彬,潘福敏,周宁峰,等.节段内修复手术治疗腰椎峡部裂及轻度峡部裂性滑脱的疗效分析[J]. 颈腰痛杂志, 2016, 37(5):361-364.
[15]	石学文,张涛,甄平,等.青少年腰椎峡部裂的致病因素及治疗进展[J].中国矫形外科杂志,2021,29(1):60-63.
[16]	陈峰,滕乐群,秦永超,等.单纯腰椎峡部裂的治疗进展[J].中华骨与关节外科杂志,2019,12(10):816-820.
[17]	张涛,屈涛,刘华,等.Wiltse入路椎弓根钉-椎板钩内固定联合自体髂骨移植修复单节段腰椎峡部裂疗效分析[J].解放军医学杂志,2020,45(7):761-766.
[18]	闫鹏,刘金辉,崔京福,等.钉棒系统固定结合峡部植骨融合治疗青少年腰椎峡部裂远期疗效[J].中国骨伤,2019,32(12):1156-1159.
[19]	蔡芝军,何晓清,浦路桥,等.双侧腰椎峡部裂钉-钩-棒固定联合植骨术[J].中国矫形外科杂志,2021,29(23):2186-2189.
[20]	陈德元,刘永恒,黄福立.椎弓根钉棒系统内固定结合自体髂骨植骨治疗青年腰椎峡部裂[J].中国骨与关节损伤杂志,2021,36(5): 491-493.