Hospital for Special Surgery, Weill Cornell Medical Center, Department of Orthopaedic Surgery, Spine & Scoliosis Service, NY, NY 10021, USA.
Spine (Phila Pa 1976). 2011 Oct 15;36(22):E1489-92. doi: 10.1097/BRS.0b013e31820285cf.
A report of two cases using custom-manufactured pedicle screws for revision spinal arthrodesis for pseudarthrosis in the setting of widely dilated pedicle screw tracts.
To present surgical outcomes of a previously unreported treatment for pseudarthrosis with widely dilated pedicle screw tracts.
Techniques for revision of lumbar pseudarthrosis with severe screw loosening and widely dilated pedicle screw tracts represent a challenging clinical scenario. If stable fixation cannot be achieved, fixation may fail or adjacent normal levels may need to be included in the construct.
Two patients presenting with painful pseudarthrosis after lumbar spinal fusion and instrumentation loosening with widely dilated pedicle screw tracts were treated with revision anterior and posterior spinal fusion using custom-manufactured large-diameter pedicle screws.
In both cases, the custom-manufactured pedicle screws achieved excellent purchase in the dilated pedicle screw tract. Both patients went on to solid fusion at 1 year after surgery.
This is a previously unreported technique for revision spinal fusion in the setting of loose instrumentation with widely dilated pedicle screw tracts.
两例使用定制的椎弓根螺钉进行翻修脊柱融合术治疗广泛扩张的椎弓根螺钉通道假关节的病例报告。
介绍一种以前未报道的治疗广泛扩张的椎弓根螺钉通道假关节的治疗方法。
对于严重螺钉松动和广泛扩张的椎弓根螺钉通道的腰椎假关节的翻修技术是一个具有挑战性的临床情况。如果不能获得稳定的固定，则固定可能会失败，或者相邻的正常节段可能需要包含在结构中。
两名患者在腰椎融合和器械松动后出现疼痛性假关节，且椎弓根螺钉通道广泛扩张，采用定制的大直径椎弓根螺钉进行前后脊柱融合翻修治疗。
在两种情况下，定制的椎弓根螺钉在扩张的椎弓根螺钉通道中都获得了良好的固定。两名患者在手术后 1 年都实现了坚固的融合。
这是一种以前未报道的技术，用于治疗带有广泛扩张的椎弓根螺钉通道的松动器械的脊柱融合翻修。
