Vavken Patrick, Krepler Petra
Department of Orthopedic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Eur Spine J. 2008 Sep;17 Suppl 2(Suppl 2):S285-90. doi: 10.1007/s00586-007-0579-4. Epub 2008 Feb 15.
Spine surgeons are becoming increasingly aware of sacral insufficiency fractures as a complication after lumbosacral fusions. We present four patients who suffered from sacral fractures after multi-segmental posterior lumbosacral fusion together with a systematic review of the literature that yielded six papers reporting on 12 cases. Summarizing these 16 cases, the typical patient suffering from this complication is a female, elderly individual [66.4 +/- 12.3 (mean +/- SD) years of age, 95% confidence interval 57.89-71] undergoing multilevel fusion of 4.9 +/- 3.4 (95% CI 3.1-6.8) segments. Due to nonspecific clinical complaints and inconclusive imaging there has been a median delay in diagnosis of 5 (IQR 3-6, range 1-49) weeks after onset of pain. It remains unclear whether this complication is rare or rather under-diagnosed. Fortunately, these fractures are predominantly benign conditions that respond well to conservative management in the majority of cases, depending on location.
脊柱外科医生越来越意识到骶骨不全骨折是腰骶部融合术后的一种并发症。我们报告了4例在多节段腰骶部后路融合术后发生骶骨骨折的患者，并对文献进行了系统回顾，共检索到6篇报道12例病例的论文。总结这16例病例，发生这种并发症的典型患者为老年女性[年龄66.4±12.3（平均±标准差）岁，95%置信区间57.89 - 71]，接受4.9±3.4（95%置信区间3.1 - 6.8）节段的多节段融合手术。由于临床症状不具特异性且影像学检查结果不明确，疼痛发作后诊断的中位延迟时间为5（四分位间距3 - 6，范围1 - 49）周。目前尚不清楚这种并发症是罕见还是诊断不足。幸运的是，这些骨折大多为良性病变，在大多数情况下，根据骨折部位不同，保守治疗效果良好。
