胸腰段骨折后路钉棒内固定手术失败原因分析

The analysis of the failure reason for internal fixations of thoracolumbar fractures

目的探讨目前临床上常见的胸腰段脊柱骨折手术后路钉棒系统内固定手术并发症的预防措施。方法总结我院自2002年以来收治的22例内固定失败病例,手术固定失败的原因:断钉16例,松棒2例,断棒2例,椎弓根钉定位错误2例。22例患者中,后凸畸形加重19例。结果 9例患者接受二次手术内固定或内固定物调整治疗;13例患者接受内固定物取出手术治疗。结论手术前应正确分析患者的手术适应证,选择正确的手术入路;熟练掌握脊柱解剖知识;部分患者要充分植骨融合。

Objective To discuss the prevention of current common clinical complications after the operation of posterior thoracolumbar spine fracture fixation screw-rod system.Methods Analyzed 22 cases underwent failure internal fixations.The reasons were broken-screw of 16,loosen rob of 2,broken-stick of 2 and fixing mistake of 2.There were 19 cases of posterior process aggravation.Results 9 patients underwent re-fixed and 13 patients underwent removed internal fixation.Conclusion We should analyze the indication correctly before operation,select an efficiently approach,master spinal column anatomy and some need fusion by successful bone graft.