Chinese Journal of Tissue Engineering Research ›› 2017, Vol. 21 ›› Issue (11): 1707-1711.doi: 10.3969/j.issn.2095-4344.2017.11.012

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Bone graft to repair isthmus defect plus temporary single segmental screw rod fixation for adolescent lumbar spondylolysis

Qu Wei1, Huang Yun-fei1, Song Zong-rang1, Wu Qi-ning1, Wang Yu-fei2   

  1. 1Department of Spine Surgery, 2Department of Orthopedics, Honghui Hospital, Xi’an Jiaotong University College of Medicine, Xi’an 710054, Shaanxi Province, China
  • Revised:2017-01-21 Online:2017-04-18 Published:2017-05-06
  • Contact: Wang Yu-fei, Master, Attending physician, Department of Orthopedics, Honghui Hospital, Xi’an Jiaotong University College of Medicine, Xi’an 710054, Shaanxi Province, China
  • About author:Qu Wei, Master, Attending physician, Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University College of Medicine, Xi’an 710054, Shaanxi Province, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81301604

Abstract:

BACKGROUND: Lumbar spondylolysis is the common cause of teenagers’ low back pain. It should apply internal

fixation if conservative treatment is invalid. There are a variety of surgeries, which aims to alleviate pain and bony fusion of pars defect.
OBJECTIVE: To observe clinical outcome of bone graft of pars defect plus temporary single segmental pedicle screw rod fixation for adolescent lumbar spondylolysis.
METHODS: A total of 32 adolescent patients of lumbar spondylolysis were treated by bone graft of pars defect plus temporary single segmental pedicle screw rod fixation. All the patients had bilateral spondylolysis. 20 patients had no lumbar spondylolisthesis, while the others had I° spondylolisthesis. All the patients received lumbar radiograph, CT and MRI. Visual analogue scale and Oswestry disability index were utilized to evaluate pain improvement before and after operation. MacNab was used to assess efficacy. Bone graft healing at isthmus was observed with lumbar CT after fixation. The internal fixation was removed after bone fusion, then the motion of the fixed segment and the degeneration of adjacent intervertebral disc occurred were recorded.
RESULTS AND CONCLUSION:(1) Completed bone fusion of pars defect was achieved in all the patients. The average period of bone union was 7.4 months. (2) The visual analogue scale and Oswestry disability index scores were significantly improved after surgery in all patients (P < 0.05). (3) The fixed segment reserved the motion after internal fixation removal. The signal of adjacent intervertebral disc of fixed segment had no changes compared to preoperative MRI. (4) Bone graft to repair isthmus defect plus temporary single segmental screw rod fixation for adolescent lumbar spondylolysis is very effective, the bone fusion is completed, and temporary fixation may effectively alleviate the degeneration of adjacent disc.

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程

Key words: Adolescent Lumbar Spondylolysis, Temporary Single Segmental Fixation, Isthmus Repair 

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