中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (13): 2429-2432.doi: 10.3969/j.issn.1673-8225.2010.13.037

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

钛金属后路椎弓根钉棒内固定系统联合椎间植骨治疗腰椎滑脱：5年同一科室36例随访

莫楚鸿，谭建基，唐灿锐   

  1. 罗定市罗定人民医院骨科，广东省罗定市  527200
  • 出版日期:2010-03-26 发布日期:2010-03-26
  • 作者简介:莫楚鸿，男，1979年生，广西壮族自治区岑溪市人，汉族，2002年广西医科大学毕业，主治医师，主要从事创伤、脊柱外科的研究。 chhmo@21cn.com

Treatment of spondylolisthesis using titanium posterior pedicle screw-rod fixation system combined with intervertebral bone grafting: A 5-year follow-up in the same institute for 36 cases

Mo Chu-hong, Tan Jian-ji, Tang Can-rui   

  1. Department of Orthopaedics, Luoding People’s Hospital, Luoding  527200, Guangdong Province, China
  • Online:2010-03-26 Published:2010-03-26
  • About author:Mo Chu-hong, Attending physician, Department of Orthopaedics, Luoding People’s Hospital, Luoding 527200, Guangdong Province, China chhmo@21cn.com

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摘要：

背景：目前临床应用治疗腰椎滑脱症的方法主要有单纯减压、前路椎体间融合、后路椎体间融合、前后路联合360 °融合等，它们都有各自的优缺点。
目的：评价GSSII系统固定联合椎间植骨治疗腰椎滑脱的效果。
方法：选择脊柱滑脱患者38例，采用标准置钉技术先在滑椎两侧的椎弓根置入2枚椎弓根螺钉，滑椎下位椎体置入2枚椎弓根螺钉，C臂机透视确认螺钉位置正确，然后咬除滑脱椎体的棘突、椎板，切除椎间盘，准备植骨床，安装连接棒，行滑椎复位。将椎板切除后的碎骨及所取髂骨植入椎间隙。调整GSS系统，扭紧连接螺钉，放置引流，关闭切口。术后8周及随访时观察手术前后脊柱放射线影像的改变，材料置入后临床症状和体征的变化，材料的生物相容性及术后骨融合情况。
结果与结论：X射线观察38例患者中36例腰椎滑脱较术前改善，其中28例完全复位，10例术后仍存在I度滑脱；术后8周X射线观察可见椎弓根钉-棒内固定器械固定可靠，未见钉、棒松脱现象，无脊柱再滑脱，脊柱稳定性良好。随访36例患者中，未出现钉、棒松脱，植骨融合好，术前的症状均得到改善，疗效评价优33例、良3例。结果证明，GSS系统钛棒可内固定治疗腰椎滑脱，操作简单、提拉复位力及螺钉抗拔出力强，是较好的固定系统。

关键词: 椎弓根钉棒内固定系统, 钛金属, 腰椎滑脱, 植骨, 硬组织植入物

Abstract:

BACKGROUND: Clinical treatments for spondylolisthesis including simple decompression, anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion (PLIF) or the 360° combination of ALIF and PLIF, which has its own characteristics.
OBJECTIVE: To evaluate the effects of GSS II system combined with interbody graft in treating spondylolisthesis.
METHODS: Totally 38 spondylolisthesis cases were selected. Firstly, 2 pedicle screws were inserted into both sides of vertebral slips, then additional 2 pedicle screws were inserted into subordinate vertebral of vertebral slips. The position of screws was confirmed by C-arm imaging machine. After that, the spinous process and vertebral plates were cut off, the bone bed was prepared, and vertebral slip was replaced. The bone fragments and ilium were grafted into intervertebral space. Finally, regulated GSS system, placed drainage, and closed the incision. X-ray changes, signs and symptoms changes, material biocompatibility, as well as bone fusion status was observed at 8 weeks after operation and in the follow-up. 
RESULTS AND CONCLUSION: X-ray films showed that spondylolisthesis of 36 cases were improved, including 28 cases with completely reduction and 10 cases with I spondylolisthesis. The pedicle screw-rod fixation system showed good stability, no screw, rod loose or shedding could be seen at 8 weeks after operation. In the follow-up of 36 cases, no shedding status could be found, and the symptoms of spodylolisthesis were improved, and therapeutic effects evaluation revealed 33 cases were excellent, and 3 cases were good. All results demonstrated that GSS system is a good fixation system with sample operation and strong anti-pull-out strength, which can be used in treating spondylolisthesis.

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