经椎间孔腰椎椎间融合术后聚醚醚酮可扩张椎间融合器失败。
Failure of a polyether-ether-ketone expandable interbody cage following transforaminal lumbar interbody fusion.
作者信息
Stein Isaac C, Than Khoi D, Chen Kevin S, Wang Anthony C, Park Paul
机构信息
University of Michigan Medical School, Ann Arbor, MI, USA.
出版信息
Eur Spine J. 2015 May;24 Suppl 4:S555-9. doi: 10.1007/s00586-014-3704-1. Epub 2014 Dec 3.
PURPOSE
Expandable cages are a more recent option for maintaining or restoring disc height and segmental lordosis with transforaminal lumbar interbody fusion (TLIF). Complications associated with expandable cages have not yet been widely reported. We report a case of postoperative failure of a polyether-ether-ketone (PEEK) expandable interbody device used during TLIF.
METHODS
A 50-year-old man presented with severe back and right leg pain after undergoing L4-5 and L5-S1 TLIFs with expandable cages and L3-S1 posterior instrumented fusion. Imaging showed retropulsion of a portion of the interbody cage into the spinal canal causing nerve compression. Displacement occurred in a delayed manner. In addition, pseudoarthrosis was present.
RESULTS
The patient underwent re-exploration with removal of the retropulsed wafer and redo fusion.
CONCLUSIONS
Expandable cages are a recent innovation; as such, efficacy and complication data are limited. As with any new device, there exists potential for mechanical failure, as occurred in the case presented.
目的
可扩张椎间融合器是经椎间孔腰椎椎间融合术（TLIF）中维持或恢复椎间盘高度及节段性前凸的一种较新选择。与可扩张椎间融合器相关的并发症尚未得到广泛报道。我们报告1例TLIF术中使用的聚醚醚酮（PEEK）可扩张椎间融合器术后失败的病例。
方法
一名50岁男性在接受L4 - 5和L5 - S1节段的可扩张椎间融合器TLIF手术及L3 - S1后路器械辅助融合术后，出现严重的腰背部及右腿疼痛。影像学检查显示椎间融合器的一部分向后突入椎管，导致神经受压。移位呈延迟性发生。此外，存在假关节形成。
结果
患者接受再次探查，取出后突的椎间融合器并重新进行融合手术。
结论
可扩张椎间融合器是一项较新的创新技术；因此，其疗效和并发症数据有限。与任何新器械一样，存在机械故障的可能性，就像本病例所发生的情况。
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