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在没有适配器械的情况下取出椎弓根螺钉的独特方法：病例报告及文献综述

Unique Procedure to Remove Pedicle Screw without Compatible Instrumentation: Case Report and Review of Literature.

作者信息

Singh Jagdeep, Gupta Pranav, Bahadur Raj, Kumar Sameer

机构信息

Department of Orthopaedics, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.

出版信息

J Orthop Case Rep. 2023 Oct;13(10):24-27. doi: 10.13107/jocr.2023.v13.i10.3922.

DOI:10.13107/jocr.2023.v13.i10.3922
PMID:37885656
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10599364/
Abstract

INTRODUCTION

As the number of patients undergoing spine fixation has increased, the requirement for revision surgery has also increased. Difficulty faced while doing revision surgery is mostly in removing polyaxial pedicle screws, especially if we do not have the desired instrumentation.

CASE REPORT

A 55-year-old patient previously operated for D12 fracture presented to us with implant failure due to backing out of pedicle screws. Compatible instrumentation to remove the implant was not available as even the cap screw could not be removed due to screwdriver mismatch. Hence, we had to design our own method to address the problem which we did successfully. At present, the patient is on our regular follow-up, is pain free, is able to walk without support, and has not reported any new complaints.

CONCLUSION

Method used in our case simplifies and accelerates the screw removal process and provides guidance to any surgeon who faces a similar problem.

摘要

引言

随着接受脊柱固定手术的患者数量增加，翻修手术的需求也在上升。翻修手术面临的困难主要在于取出多轴椎弓根螺钉，尤其是在没有所需器械的情况下。

病例报告

一名55岁曾因D12骨折接受手术的患者因椎弓根螺钉松动导致植入物失败前来就诊。由于螺丝刀不匹配，甚至连帽螺钉都无法取出，因此没有可用的兼容器械来取出植入物。于是，我们不得不设计自己的方法来解决这个问题，并且成功做到了。目前，该患者在我们的定期随访中，无痛，能够独立行走，且未报告任何新的不适。

结论

我们病例中使用的方法简化并加速了螺钉取出过程，并为任何面临类似问题的外科医生提供了指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ca/10599364/51005912ff38/JOCR-13-24-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ca/10599364/7960803d8140/JOCR-13-24-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ca/10599364/e61c768cc89a/JOCR-13-24-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ca/10599364/32145a151b81/JOCR-13-24-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ca/10599364/779e980b56d1/JOCR-13-24-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ca/10599364/51005912ff38/JOCR-13-24-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ca/10599364/7960803d8140/JOCR-13-24-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ca/10599364/e61c768cc89a/JOCR-13-24-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ca/10599364/32145a151b81/JOCR-13-24-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ca/10599364/779e980b56d1/JOCR-13-24-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ca/10599364/51005912ff38/JOCR-13-24-g005.jpg

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Cureus. 2021 May 25;13(5):e15233. doi: 10.7759/cureus.15233.
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Guideline for Thoracolumbar Pedicle Screw Placement Assisted by Orthopaedic Surgical Robot.骨科手术机器人辅助胸腰椎椎弓根螺钉置钉指南。
Orthop Surg. 2019 Apr;11(2):153-159. doi: 10.1111/os.12453.
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Poly-axial screw removal.
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Easy retrieval of polyaxial tulip-head pedicle screws by "U" rod technique.“U”棒技术可方便地取出多轴郁金香头椎弓根螺钉。
Eur Spine J. 2010 Jan;19(1):144-6. doi: 10.1007/s00586-009-1096-4. Epub 2009 Jul 18.
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