CAJ | 학술논문

目的：探讨复位固定系统(RF)、三维固定系统(TRJFIX)椎弓根系统内固定与不同部位脊椎植骨融合治疗腰椎滑脱症的效果。方法：对32例腰椎患者的神经根压迫部位针对性彻底减压，按随机化原则选择RF、TRIFIX两种椎弓根螺钉对滑脱腰椎进行复位固定，并配合椎体间与横突间植骨融合术。术后随访6个月～4年2个月，平均2年3个月。结果：滑脱椎复位率：RF与TRIFIX组均达100％。术后4个月除2例横突间植骨出现部分骨吸收外均达骨性愈合，其中椎体间植骨14例，术后平均骨性愈合时间为3个月，横突间植骨18例，术后平均骨性愈合时间3.6个月，不愈合率占11.1％。所有病人术后症状基本消失。二组均未见螺钉松动、断裂及再滑脱现象。结论：RF、TRIFIX椎弓根螺钉系统内固定能使Ⅰ、Ⅱ度腰椎滑脱完全复位，且固定牢固，有利于植骨融合。虽椎体间植骨优于横突间植骨，但扩大接触面横突间植骨仍不失为一种有效的植骨融合术式。
목적：탐토복위고정계통(RF)、삼유고정계통(TRJFIX)추궁근계통내고정여불동부위척추식골융합치료요추활탈증적효과。방법：대32례요추환자적신경근압박부위침대성철저감압，안수궤화원칙선택RF、TRIFIX량충추궁근라정대활탈요추진행복위고정，병배합추체간여횡돌간식골융합술。술후수방6개월～4년2개월，평균2년3개월。결과：활탈추복위솔：RF여TRIFIX조균체100％。술후4개월제2례횡돌간식골출현부분골흡수외균체골성유합，기중추체간식골14례，술후평균골성유합시간위3개월，횡돌간식골18례，술후평균골성유합시간3.6개월，불유합솔점11.1％。소유병인술후증상기본소실。이조균미견라정송동、단렬급재활탈현상。결론：RF、TRIFIX추궁근라정계통내고정능사Ⅰ、Ⅱ도요추활탈완전복위，차고정뢰고，유리우식골융합。수추체간식골우우횡돌간식골，단확대접촉면횡돌간식골잉불실위일충유효적식골융합술식。
Aim:Assessment of the clinical result of different ways of bone autografting in spine withRF and TRFIX pedicle screw system. Methods: 32 cases of lumbar vertebrae spondylolisthesis weretreated with the methods as following: (1) Direct decompression towards the compressed lesion area to re-lieve the compression factors . (2) Reduction and fixation of slipped vertebrae with RF and TRIFIX devicerandomly to restore the nornal anatomical curve of the vertebra. (3) Selection of posterior intervertebraefusion or intertransverse process fusion, in which the bone graft were taken from the posterior part of theillum of the patients. Results: The cases were followed up from 6 month to 4 years and 2 months,with anaverage of 2 years and 3 months. The rate of reduction were 100% in both RF and TRIFIX group. Thesolid fusion was observed in 4 months after operation for all patients but two cases. An average of 3 monthsof bone fusion were observed in all of 14 patients in intervertebrae group,while an average of 3.6 monthswere seen in 16 cases of all 18 patients in intertransverse process fusion with no fussion rate of 11.1%.All patients ' complains were disappeared after operation. There was no pedicle screw loosening or brokenand reslipped vertebrae in this series. Conclusion: RF and TRIFIX with pedicle screw system can makethe Ⅰ and Ⅱ grade of lumbar vertebrae spondylolisthesis reducted completely, fixed tightly, and bone auto-graft fusion got easily. Although the intervertebrae bone graft has more advantage over the intertransverseprocess, but the enlarged contacting site bone graft between the transverse process remains to be a kind ofeffective way in the treatment of lumbar vertebrae spondylolisthesis.