脊柱侧凸矫形手术内固定相关并发症临床分析

目的回顾性研究分析720例脊柱侧凸矫形手术术后内固定相关并发症,并探讨其发生原因及处理原则。方法选取在2009年12月之前于本院就诊并行手术矫形治疗的脊柱侧凸病例,共720例。男119例,女601例;年龄7-56岁,平均年龄14.7岁,术前Cobb’s角37°～130°,平均52.1°。结果术后随访3月～12年,平均2.6年,术后Cobb’s角平均26°,平均矫正51.2%。内固定造成脊髓损伤4例,断钉6例,断棒10例,椎板、椎弓骨折3例,曲轴现象5例,交界性后凸畸形23例。结论脊柱侧凸通过三维矫形手术可达到理想的矫形效果,提高患者生存质量,但要重视预防和处理各种内固定并发症。

Analysis and strategy of implant related complication for 720 case of scoliosis surgery

objective To retrospectively analyze the implant related complications of 720 cases of scoliosis surgery,and evaluate its strategy.Method From January 1993 to January 2009,720 patients with scoliosis underwent correction.There were 601 females and 119 males.The average age at surgery was 14.7 years.The average preoperation Cobb＇S angle was 52.1°（ranged from 37°to 130°）.Result The patients were followed up for 3months—12 years,the average Was 2.6 years.The postoperative Cobb＇S angle averaged 26°.The average correction was51.2%.Implant related complications included 4 case of spinal cord injury.16 cases of instrumentation broken,1 cases of vertebral plate fracture,2 cases of arch of vertebra fracture,5 cases of Crankshaft Phenomeno,23 cases of proxima junctional kyphos.Conclusion Satisfactory results could be obtained to treat scoliosis.