脊柱侧弯的非融合治疗

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1、EurSpineJ(2009)18:815822DOI10.1007/s00586-009-0941-9ORIGINALARTICLETreatmentofdegenerativespondylolisthesis:potentialimpactofdynamicstabilizationbasedonimaginganalysisThomasW.LawhorneIIIÆFedericoP.GirardiÆCurtisA.MinaÆIaonnisPappouÆFrankP.CammisaJrReceived:19March2008/Revised

2、:19February2009/Accepted:5March2009/Publishedonline:28March2009ÓSpringer-Verlag2009AbstractIntraspinousandpediclescrew-based(PSB)beencandidatesfordynamicstabilizationwitheitherdynamicinstrumentationsystemshavebeeninuseforainterspinousorpedicle-basedsystems.Usingthecriteriadec

3、adenow.Bydirectorindirectdecompression,theseforinstabilityoutlinedintheliterature,32patientsdem-devicestheoreticallyestablishlesspainfulsegmentalonstratedtranslationrequiringfusionsurgeryand24motionbydiminishingpathologicmotionandunloadingpatientshadinstabilityunsuitablefordy

4、namicstabiliza-painfuldisks.Ideally,dynamicsshouldaddressinstabilitytion.Sixpatientshadtwo-levelslipsandwereexcluded.intheearlystagesofdegenerativespondylolisthesisbeforeTwopatientshadcoronalimbalancetoogreatfordynamicexcessivetranslationoccurs.Evidencetodateindicatessystems.

5、Twelvepatientswereovertheageof80and16thatGradeIIorlargerslipsrequiringdecompressionshoulddemonstratedosteoporosisasdiagnosedbybonescan.befused.Inaddition,multiplesegmentlisthesis,severeFinally,wefoundtwoofourpatientstohavevertebralcoronalplanedeformities,increasingage,andoste

6、oporosiscompressionfracturesadjacenttothesiteofinstrumenta-haveallbeenlistedaspotentialcontraindicationstotion,whichisastrictexclusioncriteriainalldynamicdynamicstabilization.Wereviewedtheexclusionandtrials.Thirty-fourpatientshadzeroexclusioncriteriaforinclusioncriteriafoundi

7、nvariousdynamicstabilizationintraspinousdevicesand23patientshadnoneforPSBstudiesandinvestigationaldrugexemption(IDE)proto-dynamicstabilization.Therefore,weestimatethat34andcols.Wesummarizethereportedlimitationsforboth23%ofdegenerativespondylolisthesispatientsindicatedpedicle-

8、andintraspinous-basedsystems.Wethencon-forsurgerycouldhavebeentreate