COMPLICATIONS ASSOCIATED WITH THE TECHNIQUE OF PEDICLE SCREW FIXATION - A SELECTED SURVEY OF ABS MEMBERS

被引：589

作者：

ESSES, SI

SACHS, BL

DREYZIN, V

机构：

[1] Center for Spinal Disorders, Baylor College of Medicine, Houston, TX

[2] New England Medical Center, Boston, MA

[3] University of Toronto, Toronto

来源：

SPINE | 1993年 / 18卷 / 15期

关键词：

PEDICLE FIXATION; POSTERIOR SPINE SURGERY; LUMBAR SPINE; COMPLICATIONS;

D O I：

10.1097/00007632-199311000-00015

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

A limited survey analysis of 617 surgical cases in which pedicle screw implants were used was undertaken to ascertain the incidence and variety of associated complications. The different implant systems used included variable spinal plating (n = 249), Edwards (n = 143), and AO fixateur interne (n = 101). The most common intraoperative problem was unrecognized screw misplacement (5.2%). Fracturing of the pedicle during screw insertion and iatrogenic cerebrospinal fluid leak occurred in 4.2% of cases. The postoperative deep infection rate was 4.2%. Transient neuropraxia occurred in 2.4% of cases, and permanent nerve root injury occurred in 2.3% of cases. Previously unreported injury to nerve roots occurred late in the postoperative course in three cases. Screw breakage occurred in 2.9% of cases. All other complications had an incidence of less than 2%. The authors conclude that pedicle screw placement may be associated with significant intraoperative and postoperative complications. This information is of value to surgeons using pedicle implant systems as well as to their patients. Repeat surgery is associated with greater numbers of complications.

引用

页码：2231 / 2239

页数：9

共 24 条

[1] Aebi M., Etter C., Kehl T., Thalgott J., Stabilization of the lower thoracic and lumbar spine with the internal skeletal fixation system: Indications, techniques, and first results of treatment, Spine, 12, pp. 544-551, (1987)
[2] Aebi M., Etter C., Kehl T., Thalgott J., The internal skeletal fixation system: A new treatment of thoracolumbar fractures and other spinal disorders, Clin Orthop, 227, pp. 30-43, (1988)
[3] Cotrel Y., Dubousset J., Guillauman M., New universal instrumentation in spinal surgery, Clin Orthop, 227, pp. 10-23, (1988)
[4] Dick W., The “fixateur interne” as a versatile implant for spine surgery, Spine, 12, pp. 882-900, (1987)
[5] Esses S.I., The AO spinal internal fixator, Spine, 14, pp. 373-378, (1989)
[6] Esses S.I., Botsford D.J., Wright T., Bednar D., Bailey S., Operative treatment of spinal fractures with the AO internal fixator, Spine, 16, pp. 146-150, (1991)
[7] Gertzbein S.D., Robbins S.E., Accuracy of pedicular screw placement in vivo, Spine, 15, pp. 11-14, (1990)
[8] Gurr K.R., McAfee PC. Cotrel-Dubousset instrumentation in adults: A preliminary report, Spine, 13, pp. 510-520, (1988)
[9] Guyer D.W., Wiltse L.L., Peek R.D., The Wiltse pedicle screw fixation system, Orthopaedics, 11, pp. 1455-1460, (1988)
[10] Hehne H., Zielke K., Bohm H., Polysegmental lumbar osteotomies and transpedicle fixation for correction of long- curved kyphotic deformities in ankylosing spondylitis: Report on 177 cases, Clin Orthop, 258, pp. 49-55, (1990)

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