国内外同类研究比较:
文献来源:Steffee AD, Biscup RS, Sitkowski DJ. Segmental spine plates with pedicle screw fixation. A new internal fixation device for disorders of the lumbar and thoracolumbar [J]. Clin Orthop Relat Res, 1986,203:45~53.
主要观察指标:A new segmental spine plate fixation system, utilizing a posterior approach and screw fixation。
结论:This new system uses multiple segmental fixation points through the pedicle "force nucleus" of the vertebral body. The spine plates can be contoured for anatomic positioning, reduction, and rigid stabilization to enhance graft consolidation and fusion. The surgical fixation technique is demonstrated in five case presentations illustrating the application and versatility of the method.
文献来源:An HS,Singh K,Vaccaro AR,et al. Biomechanical evaluation of contemporary posterior spinal internal fixation configurations in an unstable burst-fracture calf spine model:special references of hook configurations and pedicle screws [J].Spine,2004,29(3):257~262.
主要观察指标:Fresh frozen in vitro study using 10 calf spines involving the T11-S1 vertebral segments. Pure moment forces including flexion, extension, axial rotation, and lateral bending were applied to the top of the spinal column at T11. Testing was first performed on all intact specimens. A corpectomy was then performed at L2. Testing was then repeated on each of the ten specimens after internal fixation with different posterior spinal configurations using ISOLA instrumentation (DePuy AcroMed Inc., Raynham, MA).
结论:The motion segment at the corpectomy site is adequately stabilized by contemporary spinal internal fixation configurations tested except for the distraction-hook stabilization. Axial rotation is generally poorly controlled by posterior-only internal fixation. Pedicle screw instrumentation was the most rigid compared with other forms of stabilization in stabilizing a burst-corpectomy defect. Based on this study, pedicle screw configurations are preferred over hook-rod strategies in the posterior stabilization of a burst-corpectomy anterior defect. Among hook-rod configurations, the distraction hook-rod strategy provided the least stability.
文献来源:Benzel EC,Rupp FW,Mc Cormack,et al. A comparison of fluoroscopy and computed tomography-derived volumetric multiple exposure transmission holography for the guidance of lumbar pedicle screw insertion [J]. Neurosurgery,1995,37(4):711~716.
主要观察指标:Pedicle screws were passed into anatomically acceptable and radiographically visualized L3-L5 pedicles in each cadaver, half using fluoroscopic guidance and half using holographic guidance alone. The accuracy of screw placement was objectively assessed by a three-point grading scale.
结论:volumetric multiple exposure transmission holography may facilitate pedicle screw placement
文献来源:李开南, 汪学军, 张进军,等.微创脊柱手术时椎弓根的体表定位解剖及临床应用[J].华西医学,2011,26(5):684-687.
主要观察指标:标本两侧胸11~腰2椎弓根中心点与棘突旁开距离(CO)、棘突上、下缘至椎弓根中心点水平面垂直距离(AC、BC),以棘突顶端的上、下缘为参照点确定椎弓根的最佳体表投影点。
结论:棘突顶端上缘为确定椎弓根中心点的最佳参照点,微创脊柱内固定术体表定位椎弓根时应根据性别和具体骨折椎体确定进针点。
文献来源:陈志伸,邵振海.脊神经后支性腰痛的解剖学和生物力学研究[J].骨与关节损伤杂志,1994,9:116~118.
主要观察指标:解剖腰段脊神经后支及其分支的走行与毗邻关系,并测定了后支在腰椎三维运动时所受的拉力
结论:1、后支从发出至过横突点是最易受损伤的部位。2、腰2后支所受牵拉力最大,最易受损伤。3、当腰椎不稳时,易发生后支性腰痛。4、X线片上有腰椎椎体后缘重影,双侧小关节间隙不对称,双侧椎弓根不对称等阳性发现是后支性腰痛诊断的参考依据。
文献来源:Sihvonen T,Hemo A,Paljarvi L,et al. Local denervation atrophy of paras pinal muscles in postoperative failed back syndrome [J]. Spine, 1993, 18:575~581.
主要观察指标:radiologic, neurophysiologic, and muscle biopsy evidence most patients (13 of 15 studied) suffering from the severe postoperative failed back syndrome
结论:Disturbed back muscle innervation and loss of muscular support leads to the disability and increased biomechanical strain and might be one important cause to the failed back syndrome. It may be possible to develop operating techniques that save back muscle innervation better than the usual ones.
文献来源:Carr D,Gilbertson L,Frymoyer JW,et al.Lumbar Paraspinal compartmented syndrome [J]. Spine, 1984,10(9):816~820.
主要观察指标:systematically review the available evidence on lumbar paraspinal compartment syndrome with specific reference to patient demographics, aetiology, types, diagnosis, clinical features, and treatment.
结论:systematically review the available evidence on lumbar paraspinal compartment syndrome with specific reference to patient demographics, aetiology, types, diagnosis, clinical features, and treatment.