Yılar Sinan, Toy Serdar
Department of Orthopedics and Traumatology, Medical Faculty of Ataturk University, Erzurum, Turkey.
Department of Orthopedics and Traumatology, Ağrı Training and Research Hospital, Ağrı, Turkey.
Int J Surg Case Rep. 2020;77:225-228. doi: 10.1016/j.ijscr.2020.10.120. Epub 2020 Nov 2.
Pedicle screws are durable and safe instruments frequently used to treat vertebra injuries and deformities. There is also a possibility of medulla spinalis and visceral organ injury when the pedicle screws are delivered in unsuitable positions or dimensions. In this case, the authors want to draw attention to one of the visceral organ injuries during the thoracic pedicle screw placement.
A 31 years old man underwent posterior instrumentation and fusion for T4 vertebra fractures. The patient was not symptomatic in the postoperative period. Tracheal pressure was observed at the 3rd thoracic vertebra level on the second day after the operation. No complications were encountered in the 3-year follow-up of the patient, who did not accept a second surgery recommended for screw replacement.
During surgery for thoracic vertebral fractures, the shoulder joint makes it difficult to imagine as the shoulder bones enter the field of view. Therefore, the number of misplaced screws increases. Moreover, it increases the risk of internal organ injury.
The use of navigation systems or cannulated pedicle screws to treat thoracic vertebral fractures reduces internal organ injuries.
椎弓根螺钉是治疗脊椎损伤和畸形常用的耐用且安全的器械。当椎弓根螺钉置入位置或尺寸不当时，也存在脊髓和内脏器官损伤的可能性。在此情况下，作者希望引起人们对胸椎椎弓根螺钉置入过程中一种内脏器官损伤的关注。
一名31岁男性因T4椎体骨折接受了后路内固定融合术。患者术后无症状。术后第二天在第3胸椎水平观察到气管受压。患者拒绝了为更换螺钉而建议的二次手术，在其3年随访中未出现并发症。
在胸椎骨折手术中，由于肩胛骨进入视野，肩关节使得操作难以想象。因此，螺钉误置的数量增加。此外，这还增加了内脏器官损伤的风险。
使用导航系统或空心椎弓根螺钉治疗胸椎骨折可减少内脏器官损伤。
