摘要
目的:分析和探讨胸腰椎骨折经椎弓根内固定后,椎弓根螺钉断裂及弯曲松动的原因。方法:对胸腰椎骨折行椎弓根内固定术(334例)并发生椎弓根螺钉断裂或弯曲松动的25例患者(33个椎体)的临床资料及随访结果进行分析。结果:经椎弓根内固定后螺钉断裂或弯曲松动的原因有:①螺钉负荷过大。②椎间盘高度的丢失。③内固定物取出过晚。④螺钉本身的设计或质量问题。⑤卧床时间过短。⑥植骨融合的问题。⑦复位不良。结论:对行经椎弓根内固定术的胸腰椎骨折患者,应根据其具体情况,选择设计合理的椎弓根内固定器械,对合并有间盘损伤及伴有脱位的病例应行植骨融合术,术后应至少卧床2￣3个月,在6￣8个月以后根据患者恢复情况尽早取出内固定物,是防止椎弓根螺钉断裂或弯曲松动的有效方法。
Objective To investigate the causes of breakage, bending and loosening of pedicle screw systems in fixation of factures of thoracic and lumbar spine. Method Pedicle screw breakage, bending and loosening were found in 25 （33 bodies of vertebra）out of 334 cases with fractures of thoracic and lumbar spine, and their clinical, materials and follow-up information were studied. Results The postoperative breakage, bending and loosening of pedicle screws were resulted from： ① overloading of pedicle screw, ② loss of the intervertebral disc heights, ③ delayed implant removal, ④ deficiency of pedicle screw design and quality, ⑤lying in bed for too short time, ⑥ question of effective bone graft, ⑦ malreduction. Conclusion Sound fusion with successful bone graft, use of rationally designed pedicle screws, correct indication selection, at least 2-3 months lying in bed and timely removal of the implant are valuable procedures for the prevention of implant failure.
出处
《吉林医学》
CAS
2006年第12期1456-1457,1459,共3页
Jilin Medical Journal
关键词
胸腰椎
内固定器
椎弓根螺钉
原因探讨
Thoracic and lumbar
Internal fixator
Pedicle screws
Cause analysis
