成年脊柱侧弯矫形后的断棒现象

Broken stick after orthopedic surgery for adult scoliosis

背景:脊柱矫形内固定疗效的好坏与植骨融合技术以及内固定材料的疲劳特性疲劳寿命直接相关。目的:分析成人脊柱侧弯矫形后发生断棒的相关因素及临床意义。方法:对9例成人脊柱侧弯矫形后断棒并进行手术治疗的患者出现断棒时间、活动度、植入物位置、植骨融合率、术中矫形率进行相关性分析。结果与结论:9例患者中6例存在椎板间植骨融合不充分现象,有明显的植骨融合空白区和假性骨岛生成。经相关分析表明,金属疲劳寿命与植骨融合率、矫形率间呈正相关(P<0.01)。提示成年脊柱侧弯患者矫形手术中良好的植骨融合条件可以保证在治疗过程中所应用的金属内固定器材处于相对稳定的抗疲劳强度状态,满足内固定治疗过程所需的条件;保证内固定棒获得低于金属固有疲劳阈值点的疲劳状态,达到有效的弹性固定和持续的矫形的目的,并避免断棒现象的发生。

BACKGROUND： The efficacy of spinal orthopedic fixation has relationship with the fatigue properties and fatigue life of the materials used in fusion and fixation technology. OBJECTIVE： To analyze the related factors of broken stick after orthopedic surgery for adult scoliosis and the clinical significance. METHODS： The time for broken rods, activity, implant location, fusion rate, rate of orthopedic surgery and other data of 9 broken stick patients with orthopedic surgery for adult scoliosis were analyzed. RESULTS AND CONCLUSION： Among the 9 patients, 6 cases with the phenomenon of un-sufficient in laminectomy, and there were obvious blank area and formation of false bone island. The analysis showed that the fatigue life had positive correlation with metal fusion rate and correction rate （P 〈 0.01 ）. Orthopedic surgery in patients with adult scoliosis fusion in good laminectomy condition can ensure the metal fixation devices applied in the treatment stay in a relatively stable state of fatigue strength to meet the fixation conditions required for the process, and can ensure the fixation of the metal rod to obtain intrinsic fatigue threshold below the point of fatigue, in order to achieve effective and sustained orthopedic fixed purpose, and to avoid the occurrence of broken rods.