ABSTRACT
Objectives:To investigate the clinical outcome of Smiley face rod fixation system for lumbar isthmic spondylolysis.Methods:From January 2016 to June 2017,18 patients with isthmic spondylolysis were treated with smiley face screw-rod fixation system.There were 13 males and 5 females,with an average age of 28.2±3.2(25-32) years old.The average disease duration was 16.3±5.7(7-24) months.L5 isthmic spondylolysis was involved in all cases.All patients had been followed up at 3 months and 1 year after surgery.The preoperative and postoperative visual analogue scale(VAS) and Oswestry disability index(ODI) were compared.The X-ray and CT scan were evaluated to analyze the change of range of motion in the lumber spine and the bony fusion rate.Results:The mean operation time was 90.0±24.1 minutes.The average blood loss was 140±15ml.The average follow-up was 18.5±5.0 (12-24) months.The VAS at 3 months after operation was 3.0±1.2,and the ODI was (17.2±4.5)％ respectively,which showed significant differences compared with the preoperative ones[7.3±2.5 and (67.0±15.1)％](P＜0.05).The VAS and ODI at 1 year after operation were 1.0± 0.6 and (9.1±5.3)％,which showed significant differences compared with 3 months postoperation(P＜0.05).The range of motion between L5 and S1 was 13.1°±2.1° and the incidence of lumbar instability was 83.3％(15/18) preoperatively;it was 9.3°±1.6° and 11.1％(2/18) postoperatively,and there was statistic difference(P＜0.05).All patients achieved bone fusion in the isthmic defect 1 year after operation.Conclusions:The Smiley face rod fixation is a reliable treatment for lumbar spondylolysis with the advantage of minimal invasive,less nerve interference,and to restore normal anatomical structure,maintain the lumbar spine stability.
ABSTRACT
The incidence of herniated lumbar disc under the age of 19 years is increasing due to increased sports activity of teenager and development of diagnostic methods. 33 cases of herniated lumbar disc of the teenager was analyzed at Department of Orthopaedic Surgery, Dong-A College of Medicine from March 1990 to May 1994. The results were obtained as follows: 1) Among 413 patients, 33 patients(7.9%) were teenagers and the sex ratio was 2.3:1 in male to female. 2) Average intervals between the onset of clinical symptoms and the admission were 13.2 months. 3) 20 cases(60.6%) had a definite trauma history, and among these cases, 14 cases(70.0%) were associated with sports activity. 4) The most common level of herniation was L4-5 in 29 cases(64.4%), straight leg raising test was positive in 32 cases(97.0%), sensory change in 13 cases(39.4%), motor weakness in 10 cases(30.3%). 5) Among positive MRI findings(32 cases), 17 cases(53.1%) were the protruded type. 6) Among 23 operative cases, 21 cases had excellent or good results.