脊柱侧凸矫形鲁氏棒内固定失败原因分析

ANALYSIS OF FIXATION FAILURE AFTER LUQUE ROD OPERATION ON SCOLI OSIS

目的 :分析脊柱侧凸鲁氏棒矫形内固定术后内固定失败的原因 ,为今后应用鲁氏棒治疗脊柱侧凸提供有益的借鉴。方法 :回顾 1 989年 1月至 1 999年 3月收治的脊柱侧凸患者应用鲁氏棒矫形内固定者 96例 ,其中由各种原因所致的内固定失败者 1 5例。结果 :分析造成内固定失败的原因为 1术前软组织松解不充分 ;2矫形过程中拧紧内固定钢丝时用力不均匀 ;3内固定钢丝数量太少 ;4植骨的数量不足 ;5内固定的节段不正确 ;6下床活动太早。结论 :应用鲁氏棒治疗脊柱侧凸仍然是一种行之有效的方法 ,但在术前准备、手术过程和术后处理时 ,应注意以上可能造成固定失败的因素。

Objective:The causes of failure of Luque rod fixation for th e s coliosis were analyzed.Methods:Ninety six patients who had the scol iosis and had been treated with Luque ro d were reviewed(between 1990 and 1998).A mong them fifteen cases had fixation fai lure.Results:The reasons wh ich caused the fixation failure were as foll ows.①The relaxation of soft tissue befor e operation was not enough.②The strength o f tightening the wires was not even.③The fixation segments were few.The quality o f bone graft was poor.④The fixation segm e nts were wrong.⑤The time of lying in bed was too short.Conclusion:Al though the treatment of scoliosis with L uque rod is a good method,the factors wh ich may cause fixation failure should be considered before and during and after the operation.