CAJ | 학술논문

目的：探讨经椎板关节突螺钉固定应用于腰骶段脊柱结核中的治疗效果及应用指征。方法：2010年3月-2013年3月收治腰骶段脊柱结核患者17例，采用后正中切口，在完成后路病灶清除植骨融合和双侧椎弓根螺钉内固定后，同一切口内经棘突根部向对侧置入经椎板关节突螺钉，进行围手术期指标观察、影像学和疗效评价。结果：所有患者均顺利完成后路病灶清除植骨融合、双侧椎弓根螺钉固定和经椎板关节突螺钉固定，无患者出现神经症状。平均手术时间(146±70)分钟，术中出血量(178±156) ml，经椎板关节突螺钉平均长度(50±4) mm。患者术后随访12～36个月，平均20个月。术后X线显示混合内固定位置良好，经棘突椎板关节突螺钉均穿过椎板和关节突关节，影像学检查所有椎体均获得椎间融合，融合率100%。结论：采用后路病灶清除植骨融合和双侧椎弓根螺钉内固定后，同一切口内置入经椎板关节突螺钉能有效提高椎间骨融合率，达到小关节稳定，解除症状的目的。
목적：탐토경추판관절돌라정고정응용우요저단척주결핵중적치료효과급응용지정。방법：2010년3월-2013년3월수치요저단척주결핵환자17례，채용후정중절구，재완성후로병조청제식골융합화쌍측추궁근라정내고정후，동일절구내경극돌근부향대측치입경추판관절돌라정，진행위수술기지표관찰、영상학화료효평개。결과：소유환자균순리완성후로병조청제식골융합、쌍측추궁근라정고정화경추판관절돌라정고정，무환자출현신경증상。평균수술시간(146±70)분종，술중출혈량(178±156) ml，경추판관절돌라정평균장도(50±4) mm。환자술후수방12～36개월，평균20개월。술후X선현시혼합내고정위치량호，경극돌추판관절돌라정균천과추판화관절돌관절，영상학검사소유추체균획득추간융합，융합솔100%。결론：채용후로병조청제식골융합화쌍측추궁근라정내고정후，동일절구내치입경추판관절돌라정능유효제고추간골융합솔，체도소관절은정，해제증상적목적。
Objective:To explore the treatment effect and indications of application of translaminar facet screw fixation in the treatment of lumbosacral spinal tuberculosis.Methods:17 cases with lumbosacral spinal tuberculosis were selected form March 2010 to March 2013.Using postmiddle approach incision,after posterior lesions cleared bone graft fusion and bilateral pedicle screw fixation,translaminar facet screw was placed opposite side from the same incision canon spines root.The perioperative indi-cators,the imaging and curative effect were observed.Results:All cases were successfully completed posterior lesions cleared bone graft fusion,bilateral pedicle screw fixation and lamina articular process screw fixation.No case had neurological symptoms.The av-erage operation time was (146 ± 70)minutes.The amount of bleeding during operation was (178 ± 156) ml.The average length of translaminar facet screw was (50±4) mm.The cases were followed up for 12~36 months,and the average was 20 months.Postoper-ative X-ray showed that hybrid fixation location was good.The translaminar facet screw all through the vertebral disc and articular process joints.The imaging examination of all vertebral body were interbody fusion,and the fusion rate was 100%.Conclusion:Using posterior lesions cleared bone graft fusion and bilateral pedicle screw fixation,and placing translaminar facet screw in the same in-cision can effectively improve the intervertebral bone fusion rate,achieve small joint stability,and relieve symptoms of purpose.