Service d'orthopédie, traumatologie et chirurgie reconstructrice, hôpital Antoine-Béclère, Assistance publique-Hôpitaux de Paris, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France.
Service de chirurgie minimale invasive, hôpital Antoine-Béclère, Assistance publique-Hôpitaux de Paris, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France.
Orthop Traumatol Surg Res. 2018 May;104(3):421-423. doi: 10.1016/j.otsr.2017.12.008. Epub 2018 Feb 7.
Immediate complications can arise due to faulty implantation of material during fusion procedures, but none have been reported in connection with ablation of material in the spine. We report a case of intraperitoneal migration of a pedicle screw during attempted removal. It crossed the psoas muscle and perforated a small-intestine loop, triggering hemorrhagic shock and peritonitis by perforation. We analyze the causes and mechanisms underlying this exceptional case of migration, with a view to sharing preventive measures. Initial extra-pedicular screw positioning and the pressure exerted to remove it were responsible for this serious incident.
融合手术过程中因材料植入不当可能会立即出现并发症，但尚未有与脊柱材料消融相关的并发症报告。我们报告了一例尝试取出时椎弓根螺钉腹腔内迁移的病例。它穿过腰大肌并刺穿一小肠环，引发失血性休克和穿孔性腹膜炎。我们分析了这种迁移的特殊情况的原因和机制，以期分享预防措施。最初的椎弓根螺钉定位和移除时施加的压力是导致这一严重事件的原因。
