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Efficacy of the Treatment of Youth Lumbar Spondylolysis by Pedicle Screw Hook System

Author: LiuHaiChao
Tutor: QianJiXian; LiCunXiao
School: Fourth Military Medical University
Course: Surgery
Keywords: Young patients Lumbar spondylolysis Fracture fixation Pedicle screw hooksystem
CLC: R687.32
Type: Master's thesis
Year: 2013
Downloads: 4
Quote: 0
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Abstract


Lumbar spondylolysis is one of the important factors which cause low back pain inyoung people, and if normal conservative treatment can not take effect, the patients needsurgery. Lumbar spinal fusion is a traditional surgery treatment, but the incidence ofadjacent segment degeneration is increased after lumbar spinal fusion. The demand on thewaist activities of young patients is very high, so it should be tried to retain the activity ofthe lumbar spine. Therefore, many researchers have been advocating a direct repairstrategy for the young patients. With the research on lumbar spondylolysis deeper anddeeper, a variety of surgical methods have been developed. Pedicle screw hook system isone of these methods which possesses unique advantages. In this study, pedicle screwhook system was used in treatment of lumbar spondylolysis in young patients fromSeptember2007to January2012in our department, and surgical efficacy was alsoevaluated. ObjectiveThis study aims to evaluate clinical outcome of pedicle screw hook system fixation indirect repair of lumbar spondylolysis in young patients, including the advantages anddisadvantages of this system, its surgical indications will be also discussed in order toprovide a valuable basis for surgical treatment for lumbar spondylolysis.MethodsThirty-one young patients suffered from lumbar spondylolysis from September2007to January2012were retrospectively analyzed to evaluate surgical treatments. The clinicaloutcome was measured using visual analogue score (VAS) and Oswestry disability index(ODI). The length of operation time, the amount of blood loss, the duration of hospital stay,the surgical complications, and the fusion status were assessed in this study. The data wereanalyzed by SPSS software.ResultsThe average operation time was130.0±18.9minutes. The average blood loss duringoperation was185.2±74.5ml. The average hospital stay after operation was10.0±2.6days.The results were from "excellent" to "good" for twenty-nine patients (93.5%) and "fair"for two of them (6.5%) according to Henderson criteria. The average preoperative VASand ODI were decreased at the last follow-up (VAS7.5±0.8vs.1.0±0.6; ODI (73.9±6.9)%vs.(10.2±4.1)%). The successful bone fusion rate was93.5%. No complications of screwor/and hook breakup, loosing or slide aside.ConclusionDefect repair using the pedicle screw hook system can provide immediate fixatio n. Itis a safe, effective and simple method. Pedicle screw hook system, as a direct repairmethod for lumbar spondylolysis, can reduce fusion segments, restore stability of lumbarvertebrae, and is very promising in the future.

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CLC: > Medicine, health > Surgery > Orthopaedic Surgery ( movement system diseases,orthopedic surgery ) > Orthopedic surgery and surgery > Bone surgery > Metal fixation
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