Development of a new screw with porous sides and its long-term efficacy for internal fixation of lumbar spondylolysis
ZHANG Fa-Hui, SONG Yi-Beng, ZHANG Chuan-Kai, CHEN Hui-Ping, ZHENG He-Beng, LI Beng, SHU Yun, SUN Yang, HAN Bing
Chinese Journal of Clinical Anatomy ›› 2013, Vol. 31 ›› Issue (4) : 461-466.
Development of a new screw with porous sides and its long-term efficacy for internal fixation of lumbar spondylolysis
Objective To investigate the long-term efficacy of using internal fixation of lumbar vertebral spondylolysis by screws with porous sides. Methods Applied of the new screw 237 patients with bilateral lumbar vertebral spondylolysis underwent internal fixation by the screws with porous sides; among the patients, 117 cases were followed up for a mean period of 8.2±7.8 cases. The spondylolysis was located at L3 in 17 cases, in L4 in 31 cases, in L5 in 69 cases; The spondylolysis was not accompanied by spondylolisthesis in 100 cases and was accompanied by I-degree spondylolisthesis and II-degree spondylolisthesis in 20 cases, respectively. All cases underwent decompression of nerve-root canal, excision of osteosclerosis at the lumbar pars and scar tissue, adhesion release of the nerves, bone implant at the bars and internal fixation by the screws with porous sides. Outcomes In the clinical study, 112 among the 117 cases who were followed up claimed total disappearance of symptoms, returning to daily work with no restriction of lumbar activity. Scores of Oswestry functional impairment index was reduced to 5.33±2.70 during the follow up from 28.37±3.99 before the treatment, suggesting significant statistical difference. ( P<0.01). JOA assessment scores improved from 19.00±2.78 before the treatment to 28.08±1.04 during the follow-up, suggesting significant statistical difference. The rate of improvement of symptoms, union of spondylolysis and correctness of spondylolisthesis was 90.34%, 99% and 80%, respectively. In all cases, no screw loosening, beak and degradation of adjacent lumbar segments were found. Conclusions The screws with porous sides can reconstruct the integrity of the motor unit of the spine through direct fixation of the fracture of the lumbar bar and stay safely in the human body in long term. Furthermore, loosening and break of the screws, and degradation of the adjacent segments after fixation can rarely happen.
Single vertebra / Adjacent segment disease / Lumbar vertebrae / Spondylolysis / Internal fixation screws with porous sides
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