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目的回顾和总结直接修复法治疗青少年腰椎椎弓崩裂的手术方式及临床疗效。方法查阅国内外关于直接修复法治疗青少年腰椎椎弓崩裂手术方式及临床疗效的相关文献,进行综述分析。结果直接修复法治疗腰椎椎弓崩裂仅在伤椎上进行简单且符合正常生理解剖的复位固定,维持其原有的解剖结构。按照文献报道的直接修复内固定方法(单一拉力螺钉固定、带钩螺钉固定、钢丝环扎内固定、椎弓根螺钉钢丝固定、椎弓根钉棒系统固定、椎弓根钉钩系统固定),青少年椎弓崩裂患者均取得了较好疗效。手术适应证的严格控制、内固定的正确选择是直接修复法获得良好疗效的保证。在各种方法中,椎弓根钉钩系统固定是一种已被广泛认同的内固定方式。结论椎弓根钉钩系统直接修复治疗青少年腰椎椎弓崩裂简便易行,疗效确实,且随着该技术的完善及微创技术的发展,其应用可能会更加广泛。
Objective To review and summarize the surgical methods and clinical effects of direct repair in the treatment of adolescent lumbar spondylolisthesis. Methods To review the domestic and foreign literatures on the surgical treatment of lumbar vertebral arch fractures and the clinical curative effect of direct repair in adolescents, and to summarize and analyze them. Results Direct repair treatment of lumbar arch fractures only in the injured vertebra simple and consistent with the normal physiological anatomy of the reset and maintain its original anatomy. According to the direct repair and internal fixation methods reported in the literature (single lag screw fixation, hook fixation, wire cerclage fixation, pedicle screw fixation, pedicle screw fixation, and pedicle screw fixation) Adolescent pedicle arch crack patients have achieved good results. Strict control of surgical indications, the correct choice of internal fixation is a direct repair method to obtain a good effect of the guarantee. Among various methods, pedicle screw system fixation is a widely accepted method of internal fixation. Conclusions The pedicle screw system is a simple and effective method for the treatment of adolescent lumbar spondylolisthesis. The application of pedicle screw system may be more extensive with the improvement of the technique and the development of minimally invasive surgery.