摘要 目的：探讨胸腰椎椎弓根内固定失败的原因。方法：回顾性分析1998年6月至2006年5月收集的胸腰椎椎弓根内固定手术失败病例共20例，其中胸腰椎骨折内固定术后10例，胸腰椎退行性疾病内固定术后8例，腰椎滑脱内固定术后2例，发现时间术后1天~48月。结果：内固定螺钉松动或断裂7例，内固定系统中的连接杆松动或退出1例，内固定松动合并感染3例，内固定螺钉进入椎管或打入椎间隙者或穿破椎体者4例，术后反复腰痛者5例，术后假关节形成2例，内固定取出后椎体高度丢失3例。结论：严格掌握手术适应证，充分准备并熟练掌握椎弓根内固定技术是胸腰椎内固定手术成功的关键。
关键词 椎弓根; 内固定;失败 ;原因分析
An Analysis of the Reason For the Failure in the Thoracolumbar Pedicle Internal Fixation
YU Ze,DONG Lele,FAN Jianjun,WANG Hongmei
( The First Affiliated Hospital of Baotou Medical College, Baotou, 014010, China)
Abstract Objective:To explore the reason for the failure in the thoracolumbar pedicle internal fixation. Methods: A retrospective analysis of 20 failed cases was made in the thoracolumbar pedicle internal fixation surgeries collected between June 1998 and May 2006, among which there were 10 postoperative cases of thoracolumbar fracture internal fixation,8 postoperative cases of internal fixation of the thoracolumbar degenerative diseases, 2 postoperative cases of lumbar Spondylolisthesis internal fixation. The failures were found at a wide range of time from one day to 48 months after operation. Results: It was found that there were 7 cases of screw loosening or breaking in the internal fixation ,1 case of connecting pole loosening or dropping, 3 cases of concurrent infection from internal fixators loosening ,4 cases of internal fixation screw entering the spinal canal ,being driven into the intervertebral space or going through the vertebra body, 5 cases of repeated postoperative lumbar pain, 2 cases of postoperative pseudoarthrosis formation,3 cases of the height loss of the vertebra body after the internal fixators was taken out.Conclusion: rigid mastery of the operation indications, full preparation and proficient mastery of the pedicle internal fixation technique are the keys to an successful thoracolumbar internal fixation surgery.
Key words Pedicle of vertebral arch;Internal fixation failur
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