Clinical results of pedicle screw fixation in spinal disorders
- VernacularTitle:椎弓根内固定技术的远期疗效评价
- Author:
Xisheng WENG
;
Guixing QIU
;
Jia ZHANG
- Publication Type:Journal Article
- Keywords:
Lumbar vertebrae;
Internal fixators;
Bone screws;
Treatment outcome
- From:
Chinese Journal of Orthopaedics
2000;0(11):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical results and safety of pedicle screw fixation for the treatment of spinal disorders. Methods From January 1988 to December 1999, 475 patients (216 males amd 259 females) with an average age of 49.1 years old in the male and an average age of 48.7 years old in the female, underwent pedicle screw fixation for spinal disorders. Diagnoses included 217 cases of spondylolisthesis, 76 lumbar stenosis, 32 degenerative lumbar spine instability, 72 thoracic or lumbar spine fractures, 60 scoliosis, and 18 others. The instrumentations were as follows: Dick 55 cases, Steffee 79 cases, CD 54 cases, RF 82 cases, DRFS 59 cases, TSRH 29 cases, USS 19 cases, SOCON 44 cases, Dynalock 24 cases, Diapson 22 cases, Tenor 5 cases, and CDH 3 cases. The fusion ranges involved one segment in 310 cases, two segments in 96 cases, and three segments in 9 cases. Hooks were applied in 60 cases. Results Four hundreds and twenty eight patients(90.l%) were followed up for (6.0?3.7)years. In the patients of degenerative spondylolisthesis, spondylolysis, lumbar stenosis, degenerative lumbar instability and thoracolumbar fracture, the amelioration of nerve function was 79.9%, 87.9%, 77.0%, 89.3%and 62.7%; the improvement of spinal motion was 90.5%, 90.9%, 83.6%, 92.9%and 52.5%; the amelioration of low back pain was 89.9%, 87.9%, 85.2%, 89.3%and 84.8%; and the amelioration of leg pain was 93.9%, 90.9%, 93.4%, 92.9%and 79.7%respectively. The mean reduction rate of degenerative spondylolisthesis, spondylolysis and spinal fracture was 90.5%, 87.9%and 91.5%respectively. The SOCON technique showed the highest reduction rate of an average of 92.3%, followed by RF of 90.8%, and Dick, Steffee and DRFS of 81.2%, while other instrumentations showed no satisfactory result in reduction. Complications occurred in 90 cases, in which 26 cases occurred during operation with the incidence of 6.1%, while 64 occurred after operation with the incidence of 15.0%. Conclusion Pedicle screws provide fixation of short segments with satisfactory clinical results and relatively high fusion rate. Perfect surgical technique is the key to reduce the incidence of complications.
