摘要
目的 探讨椎弓根螺钉系统用于胸腰椎骨折术后出现松动、断裂的原因 ,并提出相应的预防对策。方法 12例胸腰椎骨折术后内固定失效病例 ,采用RF系统 3例 ,AF系统 9例。均未行植骨融合 ,AF系统中未按要求安装横连结 3例 ,术后伤椎前缘高度平均恢复至正常的 85 2 %。结果 术后 8～ 2 1个月出现棒断裂 4例 ,螺钉断裂 3例 ,钉帽松动 5例。结论 内固定物的自身问题、术者的经验欠缺及操作不规范是胸腰椎骨折术后椎弓根螺钉系统松动、断裂的原因 ,但伤椎骨结构未能得到良好重建及术后椎间盘退变可能是其更重要的因素。因此重视内固定物的选择、加强规范操作 。
Objective To study the causes and countermeasures of postoperative loosening, breakage of pedicle screws system for thoracolumbar fracture. Methods 12 cases of pedicle screws system failure (RF3 cases, AF9 cases) in thoracolumbar fracture were enrolled. All of the cases were not performed bone graft. The conjunction rods were not used regularly in 3 cases. The anterior height of injured vertebrae body restored to 82 5% postoperatively. Results In the 8～21 months' follow up, rods broke in 4 cases, screws broke in 3cases, and nuts loosened in 5 cases. Conclusion Althought the intrinsic problem of fixator, poor experiment of surgeon and irregular procedure could lead to fixation failure, the more important causes should be dissatisfactory reconstruction of injured vertebrae body and disc degeneration postoperatively. Proper selection of inter fixation, standardization of procedure and overall treatment of vertebral body and disc are the effective way to prevent inter fixation failure postoperatively.
出处
《临床骨科杂志》
2003年第4期307-310,共4页
Journal of Clinical Orthopaedics
关键词
脊柱骨折
骨折固定术
内
治疗失败
预防
spinal fractures
fracture fixation, internal
treatment failure
prevention
