胸腰椎AF、RF椎弓根钉系统的手术后并发症

目的：了解ＡＦ、ＲＦ椎弓根钉系统常见并发症，分析手术失误原因。方法：回顾分析１９９５年以来，应用ＡＦ、ＲＦ椎弓根系统治疗各类胸腰椎疾患６０例，对手术疗效，手术后并发症，手术失误原因进行了随访总结。结果：６０中例超过半年以上的完整病史５５例。胸腰椎骨折行ＡＦ钉复位内固定４５例，腰椎滑脱症行ＲＦ钉复位内固定１０例。平均随访时间３２个月，优良率８２％。 主要并发症是：钉位差、内固定物松动折断、伤口感染等

The postoperative complications of AF&RF pedicle screw in thoracolumbar fracture

Aim:To analyse the common surgery complications of AF&RF pedicle screws systems,and the reason of its failure.Methods:60 patients of thoracolumbar spinal diseases who were fixed with AF&RF pedicle screw systems from 1995 were reviewed,complications and failures of the surgeries were summarized.Results:55 of 60 cases were followed up over six months,45 patients of thoracolumbar spinal fractures were treated with AF,10 patients of spondylolisthesis were treated with RF.The average follow up is 32 months;the rate of excellent and good results is 82%.The main surgery complications are malposition of screw,screw loosen and broken,wound infection,etc.The rate of surgery complications is 23%.Conclusions:(1)It is better for operating in one week after thoracolumbar spinal fractures.(2)It is not appropriate for fixing from posterior approach when the fracture is over two weeks or complicated with ruptures of the anterior and posterior longitudinal ligaments.(3)Bone graft must be used,when reduction is unsatisfactory or the height of the fracure vertebra does not restore.(4)Whether RF pedicle screw with bone graft between transverse process in spondylolisthesis could miantian spinal stability remain for further discussion.We think it is better for using interbody fusion in spondylolisthesis.