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改良scott法
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     Scott (1977) and C.
     Scott(1977),C.
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     In breeding of polyploid of Brassica oleracea L.var.
     用改良L.
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     The improvement A.
     改良 A .
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     The Modified Scott Wiring Technique for Direct Repair of Lumbar Spondylosis in Young Patients
     改良Scott治疗青年性腰椎椎弓崩裂
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     Modified Scotts Technique for the Treatment of Lumbar Spondylolysis- Factors Affecting Posterolateral Fusion Rate
     改良Scott技术治疗腰椎峡部裂——植骨融合探讨
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Objective To evaluate the biomechanical performance and clinical results of hook plus screw fixation after direct repair of lumbar spondylolytic defects in the pars interarticularis.Methods Eight fresh-frozen and thawed calf cadaveric lumbar L2-L6 spines were used for mechanical testing.The bilateral spondylolytic defects were created in the L4 vertebra.The intervertebral rotation(L4 and L5) were scanned and computerized when flexion/extension,lateral bending and torsion loading were applied on the intact spine,spondylolytic...

Objective To evaluate the biomechanical performance and clinical results of hook plus screw fixation after direct repair of lumbar spondylolytic defects in the pars interarticularis.Methods Eight fresh-frozen and thawed calf cadaveric lumbar L2-L6 spines were used for mechanical testing.The bilateral spondylolytic defects were created in the L4 vertebra.The intervertebral rotation(L4 and L5) were scanned and computerized when flexion/extension,lateral bending and torsion loading were applied on the intact spine,spondylolytic spine and spondylolytic spine fixed by modified Scott's fixation,hook plus screw fixation and Buck's fixation sequentially and respectively.From July 2002 to February 2004,14 young male cases suffered from symptomatic lumbar spondylolysis were selected to be treated with hook screw fixation after direct repair of the defect.MacNab criteria were used to assess their pre-and post-operative status.Results Each fixation technique significantly increased stiffness and returned the intervertebral rotational stiffness nearly to intact levels.Hook plus screw technique provided more rotational stability than the other two techiniques.Hook plus screw and Buck's technique also could provide more flexion/extension stability than the modified Scott's technique.Neither complications nor instrumentation failure were observed.The follow up for mean 21 months showed good or excellent results in 13 cases according to MacNab criteria but unilateral nonunion in one.Conclusion Hook plus screw fixation can reduce fusion segments and recover stability of the lumbar vertebrae and is simple,safe and effective clinically.

目的评价腰椎弓崩裂直接修复后采用椎板钩-椎弓根钉固定的生物力学作用,并探讨其应用于青年患者的临床价值。方法选用8具新鲜小牛腰椎标本,于L4制作椎弓崩裂模型,按正常标本组、峡部裂组、改良Scott固定组、钩钉固定组和Buck螺钉固定组顺序分别测量腰椎不同运动状态下的稳定性。2002年7月-2004年2月,14例男性单纯腰椎弓崩裂患者(15~31岁)接受自体骨直接修复峡部裂后椎板钩、椎弓根钉固定术,随访并根据影像学结果及M acNab标准进行临床评价。结果3种内固定方式均能有效恢复腰椎稳定性,钩钉法在抗旋转不稳方面更优于Buck钉及改良Scott法,同时钩钉法和Buck钉固定法在提高屈曲稳定性方面优于改良Scott法。临床病例无手术及内固定相关的并发症发生,平均随访21个月,除1例术后单侧椎弓崩裂处不融合外,其余患者均获得植骨愈合。按M acNab标准:优、良13例,一般1例。结论椎板钩-椎弓根钉应用于青年性腰椎弓崩裂直接修复后固定可在减少融合节段的同时能有效恢复腰椎稳定;临床应用简便、安全、有效。

Objective To evaluate the clinical effect of modified Scott wiring technique for direct repair of lumbar spondylosis in young patients.Methods 12 young cases with lumbar spondylosis were treated with isthmic debriment,local bone graft and fixation by modified Scott wiring technique.Results All patients were followed up for 6~19 months,13 on the average.The lower lumbar pain disappeared in 12 patients.According to the MacNab′s scores,the result were excellent in 8 cases,good in 3, fair in 1,and the excellent...

Objective To evaluate the clinical effect of modified Scott wiring technique for direct repair of lumbar spondylosis in young patients.Methods 12 young cases with lumbar spondylosis were treated with isthmic debriment,local bone graft and fixation by modified Scott wiring technique.Results All patients were followed up for 6~19 months,13 on the average.The lower lumbar pain disappeared in 12 patients.According to the MacNab′s scores,the result were excellent in 8 cases,good in 3, fair in 1,and the excellent and good rate was 91.7%.No pedical screw and wire looseness or breakage was found.The x-ray film showed that the spondylolysis got fusion in all cases.Conclusion The modified Scott wiring technique for direct repair of lumbar spondylosis is accorded with anatomy in young patient,which is effective and requires simple manipulation.But still needs careful selection of patients.

目的评价改良Scott法治疗青年性腰椎椎弓崩裂的临床疗效。方法对12例青年性腰椎椎弓崩裂患者进行峡部修理、植骨,而后行改良Scott法内固定。结果12例随访时间6-19个月,平均13个月。患者下腰痛或放射痛等症状显著缓解,按MacNab′s标准,优8例,良3例,一般1例,优良率为91.7%。未见椎弓根螺钉及钢丝松动、断裂,X线融合率为100%。结论改良Scott法是一种符合正常生理解剖的治疗青年性腰椎椎弓崩裂的方法,简单易行,疗效显著,但需掌握适应证。

 
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