中国骨科临床与基础研究杂志
中國骨科臨床與基礎研究雜誌
중국골과림상여기출연구잡지
Chinese Journal of Clinical and Basic Orthopaedic Research
2015年
5期
269-274
,共6页
尹知训%何二兴%郭倞%陈镜臣%郭练锦%高巨州
尹知訓%何二興%郭倞%陳鏡臣%郭練錦%高巨州
윤지훈%하이흥%곽경%진경신%곽련금%고거주
腰椎滑脱%椎间隙狭窄%椎间撑开器%内固定器
腰椎滑脫%椎間隙狹窄%椎間撐開器%內固定器
요추활탈%추간극협착%추간탱개기%내고정기
Lumar spondylolisthesis%Intervetbral stenosis%Intervertebral spreader%Internal fixators
目的 设计研制具有自主知识产权的腰椎间撑开器,探讨其在腰椎滑脱复位中的应用价值.方法 根据国人腰椎解剖特点,在Solidworks软件平台上设计并定制一套厚度递增的腰椎间撑开器.对2013年7月至2014年7月广州医科大学附属第一医院收治的12例腰椎滑脱伴严重椎间狭窄患者,行腰椎间撑开器单侧椎间孔椎间复位、双侧经皮椎弓根钉棒内固定术,回顾性分析其临床资料,观察腰椎间撑开复位和相关并发症发生情况.结果 手术时间90~150 min,平均手术时间110 min;术中出血量120~300 mL,平均出血量150 mL.术中未出现神经根、硬脊膜囊损伤.12例患者均获有效随访,随访时间3~15个月(平均7.5个月).术后1周、3个月、末次随访腰腿痛视觉模拟量表(VAS)评分、腰椎滑脱间隙高度、腰椎滑脱距离均明显优于术前(P <0.05);末次随访时腰痛、腿痛VAS评分平均改善率分别为68.9%、68.1%,平均腰椎滑脱改善率为91.8%.完全复位5例,基本复位7例.随访期间未发现断钉断棒及融合器退出、下沉并发症.结论 自行研制的腰椎间撑开器安全实用,能有效撑开严重狭窄的腰椎间隙,辅助腰椎滑脱复位.
目的 設計研製具有自主知識產權的腰椎間撐開器,探討其在腰椎滑脫複位中的應用價值.方法 根據國人腰椎解剖特點,在Solidworks軟件平檯上設計併定製一套厚度遞增的腰椎間撐開器.對2013年7月至2014年7月廣州醫科大學附屬第一醫院收治的12例腰椎滑脫伴嚴重椎間狹窄患者,行腰椎間撐開器單側椎間孔椎間複位、雙側經皮椎弓根釘棒內固定術,迴顧性分析其臨床資料,觀察腰椎間撐開複位和相關併髮癥髮生情況.結果 手術時間90~150 min,平均手術時間110 min;術中齣血量120~300 mL,平均齣血量150 mL.術中未齣現神經根、硬脊膜囊損傷.12例患者均穫有效隨訪,隨訪時間3~15箇月(平均7.5箇月).術後1週、3箇月、末次隨訪腰腿痛視覺模擬量錶(VAS)評分、腰椎滑脫間隙高度、腰椎滑脫距離均明顯優于術前(P <0.05);末次隨訪時腰痛、腿痛VAS評分平均改善率分彆為68.9%、68.1%,平均腰椎滑脫改善率為91.8%.完全複位5例,基本複位7例.隨訪期間未髮現斷釘斷棒及融閤器退齣、下沉併髮癥.結論 自行研製的腰椎間撐開器安全實用,能有效撐開嚴重狹窄的腰椎間隙,輔助腰椎滑脫複位.
목적 설계연제구유자주지식산권적요추간탱개기,탐토기재요추활탈복위중적응용개치.방법 근거국인요추해부특점,재Solidworks연건평태상설계병정제일투후도체증적요추간탱개기.대2013년7월지2014년7월엄주의과대학부속제일의원수치적12례요추활탈반엄중추간협착환자,행요추간탱개기단측추간공추간복위、쌍측경피추궁근정봉내고정술,회고성분석기림상자료,관찰요추간탱개복위화상관병발증발생정황.결과 수술시간90~150 min,평균수술시간110 min;술중출혈량120~300 mL,평균출혈량150 mL.술중미출현신경근、경척막낭손상.12례환자균획유효수방,수방시간3~15개월(평균7.5개월).술후1주、3개월、말차수방요퇴통시각모의량표(VAS)평분、요추활탈간극고도、요추활탈거리균명현우우술전(P <0.05);말차수방시요통、퇴통VAS평분평균개선솔분별위68.9%、68.1%,평균요추활탈개선솔위91.8%.완전복위5례,기본복위7례.수방기간미발현단정단봉급융합기퇴출、하침병발증.결론 자행연제적요추간탱개기안전실용,능유효탱개엄중협착적요추간극,보조요추활탈복위.
Objective To design and develop a lumbar intervertebral spreader with independent intellectual property rights for expanding the intervertebral space,and to discuss the application value in the reduction of lumbar spondylolisthesis.Methods According to the anatomic characteristics of Chinese human lumbar spine,a set of intervertebral spreaders with increasing thickness was designed on the Solidworks software platform,and made by a medical apparatus manufacturer.With this self-designed device,12 patients of lumbar spondy-lolisthesis with serious intervertebral stenosis underwent unilateral transforaminal interbody spondylolisthesis reduction combined with bilateral percutaneous pedicle screw-rod internal fixation from July 2013 to July 2014 in First Affiliated Hospital of Guangzhou Medical College,and their clinical data were analyzed retrospectively. The interbody traction and reduction during the operation were observed,and the relative complications were recorded.Results The average operative time was 110 min (90-150 min),the average intraoperative estimate blood loss was 150 mL (120-300 mL).No nerve root or dural injuries were found during the procedure.The patients were followed up from 3 to 15 months (average,7.5 months).At 1 week,3 months after the surgery,as well as the last follow-up,visual analogue scale (VAS) scoring,intervertebral space height and the distance of lumbar spondylolisthesis were all improved compared with preoperative ones (P <0.05); At the last follow-up,the average improvement rate of VAS of back pain and leg pain was 68.9%,68.1% respectively,and the improvement rate of lumbar spondylolisthesis was 91.8%.There was complete reduction in 5 cases,and nearly complete reduction in 7 cases.No screw-rod breakage or Cage migration,subsidence had happend during the follow-up.Conclusion The self-designed lumbar intervertebral spreader has been proved to be safety and practical which is effective for expanding intervertebral space with severe stenosis,so as to be helpful for the reduction of lumbar spondylolisthesis.
