中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (26): 4911-4914.doi: 10.3969/j.issn.1673-8225.2011.26.040

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

颈椎前路钛板置入内固定后螺钉松动3例

薛厚军1，雷  高1，罗德民1，潘  磊2，方国芳1，张丁城1，周健和1，潘合科1   

  1. 1东莞康华医院脊柱关节外科，广东省东莞市523080
    2佛山市三水区人民医院脊柱创伤外科，广东省佛山市528100
  • 收稿日期:2011-02-26 修回日期:2011-05-05 出版日期:2011-06-25 发布日期:2011-06-25
  • 作者简介:薛厚军★，男，1981年生，安徽省巢湖市人，汉族，中山大学在读硕士，医师，主要从事脊柱外科方面的研究。 guxuepiao2000@yahoo.com.cn

Three cases of screw loosening following anterior cervical plate fixation

Xue Hou-jun1, Lei Gao1, Luo De-min1, Pan Lei2, Fang Guo-fang1, Zhang Ding-cheng1, Zhou Jian-he1, Pan He-ke1   

  1. 1Department of Spinal and Joint Surgery, Kanghua Hospital, Dongguan  523080, Guangdong Province, China
    2Department of Traumatic Spinal Surgery, Sanshui District People’s Hospital of Foshan, Foshan  528100, Guangdong Province, China
  • Received:2011-02-26 Revised:2011-05-05 Online:2011-06-25 Published:2011-06-25
  • About author:Xue Hou-jun★, Studying for master’s degree, Physician, Department of Spinal and Joint Surgery, Kanghua Hospital, Dongguan 523080, Guangdong Province, China guxuepiao2000@yahoo.com.cn

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762

被引次数

2

摘要：

背景：对于保守治疗效果不佳的颈椎病患者及颈椎外伤后椎间盘突出或椎体骨折压迫脊髓出现神经根神经症状者，颈椎前路椎间盘切除、椎体次全切植骨/钛笼固定仍然是其主要治疗方式。
目的：总结颈前路钛板内固定后螺钉松动的原因及防治策略。
方法：纳入41例颈椎病和颈椎损伤患者，根据手术适应证选择经前路颈椎间盘切除、椎体次全切行颈椎前路钛板内固定，内固定后有3例出现螺钉钛板松动，分析其发生原因并提出防治方法，以减少颈前路钛板螺钉松动的发生率。
结果与结论：3例螺钉松动患者均出现不同程度的吞咽困难症状，确诊后2周内行2次手术，调整螺钉位置后重新固定钛板，远期观察患者内固定位置良好，症状缓解。提示适应证及置入方法的选择，内固定器材的合理应用，正确的置入后管理是预防颈前路钛板内固定后螺钉松动的关键。

关键词: 颈前路, 钛板, 内固定, 螺钉, 松动

Abstract:

BACKGROUND: Anterior cervical discectomy and subtotal vertebrectomy/titanium cage fixation are the main therapies for patients with poor outcomes of conservative treatment for cervical spondylosis or those with neurological symptoms of the nerve root following cervical injuries or vertebral fractures.
OBJECTIVE: To conclude the reasons and preventive measures for screw loosening following anterior cervical plate fixation.
METHODS: Among 41 cases of cervical spondylosis and cervical injuries undergoing anterior cervical fixation plate, there were 3 cases of screw loosening. The causes and control methods were analyzed and proposed to reduce the anterior plate incidence of screw loosening.
RESULTS AND CONCLUSION: Three cases of screw loosening presented with varying degree of dysphasia. After diagnosed, second operation was performed within 2 weeks to adjust the position of re-fixed titanium screw, and the long-term observation showed patients with good symptom relief. The surgical indications and the choice of the rational application of internal fixation devices as well as the correct postoperative management is the key to prevent screw loosening.

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