Tamburrelli F C, Perna A, Proietti L, Zirio G, Santagada D A, Genitiempo M
UOC Vertebral Surgery, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy.
Institute of Orthopedic Clinic, Università Cattolica del Sacro Cuore, Rome, Italy.
Malays Orthop J. 2019 Nov;13(3):39-44. doi: 10.5704/MOJ.1911.007.
Posterior percutaneous instrumentation may represent a challenge when multiple levels need to be instrumentated, especially when including the upper thoracic spine. The aim of the present study was to evaluate the technical feasibility and the long-term outcome of such long constructs in different surgical conditions. This investigation was a retrospective cohort study which included patients who underwent thoraco-lumbar percutaneous fixations. We collected clinical, surgical and radiological data, with a minimum follow-up of 24 months. Health-related quality-of-life, residual pain, instrumentation placement, and complications were studied. A total of 18 procedures were enrolled, in which 182 screws were implanted, (170 positioned in thoracic and 12 in lumbar pedicles, respectively). No surgical complications or hardware failure occurred in our series, 6 out of 182 (3,2%) screws had a partial pedicle breach, without neurological impairment or need for surgical revision. According to our results, a fully posterior percutaneous approach for long thoraco-lumbar spine instrumentation can be considered safe and reproducible, although an adequate training is strictly required.
当需要对多个节段进行器械固定时，尤其是包括上胸椎时，后路经皮器械固定可能具有挑战性。本研究的目的是评估在不同手术条件下这种长节段固定的技术可行性和长期疗效。本调查是一项回顾性队列研究，纳入了接受胸腰椎经皮固定的患者。我们收集了临床、手术和放射学数据，随访时间至少为24个月。对与健康相关的生活质量、残余疼痛、器械置入情况和并发症进行了研究。共纳入18例手术，植入了182枚螺钉（分别有170枚位于胸椎椎弓根和12枚位于腰椎椎弓根）。我们的系列研究中未发生手术并发症或内固定失败，182枚螺钉中有6枚（3.2%）出现部分椎弓根穿孔，未出现神经功能损害或手术翻修的需要。根据我们的结果，尽管严格需要充分的培训，但对于长节段胸腰椎脊柱器械固定，完全后路经皮入路可被认为是安全且可重复的。
