矢状面失衡手术的失败与翻修：影响失败的因素分析
Failures and revisions in surgery for sagittal imbalance: analysis of factors influencing failure.
作者信息
Berjano P, Bassani R, Casero G, Sinigaglia A, Cecchinato R, Lamartina C
机构信息
IVth Spine Surgery Division, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy,
出版信息
Eur Spine J. 2013 Nov;22 Suppl 6(Suppl 6):S853-8. doi: 10.1007/s00586-013-3024-x. Epub 2013 Sep 24.
Abstract
INTRODUCTION
Sagittal imbalance is an important risk factor for spinal disability, pain and loss of health related quality of life. Its correction has a positive impact on these outcomes. Still, it is a very aggressive surgery, with a high revision rate. The aim of this study is to analyze the most important causes of failure of surgery for correction of sagittal imbalance.
DESIGN AND METHODS
In this retrospective observational cohort study twelve patients who previously underwent surgery for sagittal imbalance correction were revised in the period 2009-10. We analyzed angular parameters of sagittal balance before and after primary surgery, type of instrumentation, modality of fusion, implant density, instrumented levels, modality of failure, time from first surgery and angular parameters after revision.
RESULTS AND CONCLUSION
Causes of failure were insufficient correction, junctional kyphosis, screw loosening and pseudoarthrosis with rod breakage. In every case, patients presented a new onset or a worsening of sagittal imbalance and pain.
摘要
引言
矢状面失衡是导致脊柱残疾、疼痛及健康相关生活质量下降的重要危险因素。对其进行矫正会对这些结果产生积极影响。然而，这是一种极具侵袭性的手术，翻修率很高。本研究的目的是分析矢状面失衡矫正手术失败的最重要原因。
设计与方法
在这项回顾性观察队列研究中，对2009年至2010年期间12例先前接受矢状面失衡矫正手术的患者进行了翻修。我们分析了初次手术前后矢状面平衡的角度参数、内固定类型、融合方式、植入物密度、固定节段、失败方式、首次手术后的时间以及翻修后的角度参数。
结果与结论
失败原因包括矫正不足、交界性后凸、螺钉松动以及假关节伴棒断裂。在每种情况下，患者均出现矢状面失衡和疼痛的新发或加重。
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