胸腰椎椎弓根钉内固定术并发症的分析

目的：分析胸腰椎椎弓根钉并发症的原因，找到更好的预防措施。方法：回顾性分析1999年1月－2000年3月60例接受胸腰椎椎弓根钉内固定手术的患者，共264枚椎弓根钉，并对其中12名术后有不适症状，共60枚椎弓根钉，做了X线片及CT扫描对比分析，结果：本组病例接受椎弓根钉内固定术的并发症的发病率为20％，腰背痛4例，下肢感觉麻木，酸胀3例，下肢放射痛2例，肌力减弱1例，异物排斥反应，伤口不愈2例，因椎弓根钉内固定技术不正确或不规范而导致的失误：X线片发现4例8枚，CT片发现12例23枚，结论：胸腰椎椎弓银钉内固定术的并发症并非少见，通过术后X线片，尤其CT扫描检查，可以在影像学上找到直接原因，必要时二次手术解决，选择合适的，可靠的内固定物及工具，规范，严格地手术操作，并发症会降低。

An Analysis about Complication Associated with the Pedicle Screw Fixation in the Treatment of Thoracolumbar Disease

Objective: To analyze the complication associated with the pedicle screw fixation in the thoracolumbar disease, looking for theprevention of the complications.Methods: The authors reviewed 60 cases who were fixated with pedicle screw in thoracolumbar disease from Jan.1999 to March 2000,included 264 screws;and contrastively analysis 12 cases with discomfort by X-ray and CT,included 60 screws.Results: The complication rate was 20%.There were 4 cases pain in the back,3 cases anesthesia and ache in the lower limbs,2 cases radioactive pain in the lower limbs,1 case muscular power weakened,2 wounds did not healed.The mistakes which associated with the technique of pedicle screw fixation were found through roentgenography.There were 8 screws of 4 cases by X-ray,there were 23 screws of 12 cases by CT.Conclusion The complication associated with the pedicle screw fixation was not a few.It could be found directly cause through roentgenography and it should be reoperated ,if it was necessary.It will depress the complication if you choose a suitable,credible appliance and tools,and do a standard strict operation.