颈椎后路融合术后机械植入物失败。
Mechanical implant failure in posterior cervical spine fusion.
机构信息
Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
出版信息
Eur Spine J. 2012 Feb;21(2):328-34. doi: 10.1007/s00586-011-2043-8. Epub 2011 Oct 16.
PURPOSE
The aim of this study was to determine whether the recent refinement and downsizing of the implants for posterior cervical fusion increase the occurrence of implant failure.
METHODS
One hundred forty-two consecutive cases of cervical fusion, using either cannulated Magerl screws or a multiaxial pedicle screw-rod system, were reviewed retrospectively after an average follow-up period of more than 3 years, and the rate and characteristics of the failure of these implants were evaluated.
RESULTS
Implant failure occurred in six (4.2%) patients: five with rheumatoid arthritis and one with athetoid cerebral palsy. Occipital plate fracture occurred in two patients, Magerl screw breakage in one patient, cervical pedicle screw fracture in two patients, and disassembly of the pedicle screw and rod in two patients (one with an occipital plate fracture). There was no rod fracture. The implant failures were asymptomatic, except in one patient. Disassembly of the pedicle screw and rod was observed immediately after another surgical procedure under general anesthesia in two patients.
CONCLUSIONS
The failure rate of 4.2% was similar to the rates reported in the literature for posterior lumbar spinal fusion, confirming the reliability of the recent cervical screw-rod system.
目的
本研究旨在确定最近对颈椎后路融合术用植入物的改进和缩小是否会增加植入物失败的发生。
方法
回顾性分析了 142 例连续接受颈椎融合术的患者（使用空心 Magerl 螺钉或多轴椎弓根螺钉-棒系统）的资料，平均随访时间超过 3 年，评估这些植入物失败的发生率和特征。
结果
6 例（4.2%）患者发生植入物失败：5 例为类风湿关节炎，1 例为手足徐动型脑瘫。2 例患者出现枕骨板骨折，1 例患者出现 Magerl 螺钉断裂，2 例患者出现颈椎椎弓根螺钉断裂，2 例患者出现椎弓根螺钉和棒分离（其中 1 例伴有枕骨板骨折）。无棒断裂。除 1 例患者外，其余植入物失败患者均无症状。2 例患者在全麻下行另一项手术时，立即发现椎弓根螺钉和棒分离。
结论
失败率为 4.2%，与文献报道的后路腰椎融合术的失败率相似，证实了最近的颈椎螺钉-棒系统的可靠性。
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