【摘要】 目的探讨胸腰椎骨折经椎弓根螺钉系统内固定后,螺钉断裂的可能原因。方法 382例胸腰椎骨折患者行经椎弓根螺钉系统内固定手术,有24例发生螺钉断裂,对内固定失败的原因进行分析。结果 382例患者经过1~5.6年的随访(平均2.8年),24例发生内固定失败,均表现为椎弓根螺钉断裂。结论椎弓根螺钉系统内固定失败的主要原因有:手术适应证和手术入路选择不当;忽视了前柱的重建;骨折节段未作植骨融合或融合不牢;医师操作技术不够熟练;螺钉设计和螺钉选择不当;术后未采用支具保护或是过早负重;内置物取出过迟。更多还原

【Abstract】 Objective To analyse the causes of pedicle screw breakage in pedicle screw internal fixation system for thoracolumbar fractures.Methods 382 cases of thoracolumbar fractures were treated with pedicle screw system in our hospital.Broken pedicle screw were found in 24 cases.This study investigated the pedicle screw breakage by conducting retrieval analyses of broken pedicle screws from 24 patients.Results All patients were followed-up from 1to 5.6 years with an average of 2.8 years.Broken pedicle screws were found in 24 cases.Conclusion The major reason for the failure of pedicle screw fixation were as follows: non-strict indications and inappropriate approach;ignore restoration of a stable anterior column;bone graft was not used and the fusion was incomplete;unskilled;deficiency of the pedicle screw design;no thoracolumbar protective brace had been adopted postoperatively and earlier weight bearing;delayed implant removal.更多还原