| 腰椎滑脱术后失效翻修初步探讨 |
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Received:January 21, 2008
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| 期刊信息：《中国骨伤》2008年21卷，第4期，第257-259页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的：探讨腰椎滑脱术后失效的原因、翻修对策及疗效。
方法：8例腰椎滑脱术后失效翻修患者，男3例， 女5例；年龄42～71岁，平均54岁。其中椎弓根螺钉断裂6例，椎间融合器塌陷、椎弓根螺钉断裂1例，骨质疏松、内植物松动1例。临床症状有畸形、局部疼痛、下肢疼痛麻木等。翻修行后路减压、复位，椎体间、后外侧植骨，经椎弓根加粗和(或)加长螺钉内固定。
结果： 所有患者术后获6～24个月随访，平均16个月。 翻修术后患者原有症状基本缓解，手术总优良率87.5%.无术后感染并发症，均获得骨性融合。
结论：技术性原因是造成腰椎滑脱术后失效的主要原因。后路椎弓根螺钉复位内固定加椎体间、后外侧植骨融合术不失为有效翻修方法之一，手术操作规范是翻修疗效满意的关键。 |
| [关键词]:腰椎 脊椎滑脱 治疗失败 手术后并发症 脊柱融合术 |
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| Preliminary studies on revision of the failed surgery for lumbar spondylolisthesis |
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Abstract:
Objective: To study the causes of failure in the treatment of lumbar spondylolisthesis, and revision techniques and therapeutic effects.
Methods: Eight cases with failed spondylolisthesis surgery were treated. There were 3 male and 5 female with an average age of 54 years old,ranging from 42 to 71 years. Among them,there were 6 cases of pedicle screws breakage,1 case of fusion cage sinking and pedicle screws breakage,1 case of osteoporosis and pedicle screws loosening. Their clinical symptoms included deformity,local pain,leg pain and numbness. The revision surgery was performed by the posterior decompression,instrumentation,intervertebral and posterolateral bone grafting, in which large diameter or long screws were applied for pedicle screws fixation.
Results: All cases were followed-up from 6 to 24 months after revision(mean,16 months). The clinical result was satisfied and the excellent or good results were 87.5%. There was no infection and other major complications. All patients had achieved solid fusion.
Conclusion: Poor technique and skill are considered as the primary causes leading to surgical failure of lumbar spondylolisthesis. The satisfactory outcome could be obtained by appropriately using the revision techniques. |
| KEYWORDS:Lumbar vertebrae Spondylysis Treatment failure Postoperative complications Spinal fusion |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陆建华,张烽.腰椎滑脱术后失效翻修初步探讨[J].中国骨伤,2008,21(4):257~259 |
| 英文格式: | LU Jian-hua,ZHANG Feng.Preliminary studies on revision of the failed surgery for lumbar spondylolisthesis[J].zhongguo gu shang / China J Orthop Trauma ,2008,21(4):257~259 |
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