中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (39): 7307-7310.doi: 10.3969/j.issn.1673-8225.2011.39.022

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

置入椎间融合器行腰椎融合后Cage移位的原因

苗惊雷,张朝跃,詹瑞森,李志跃,刘振东   

  1. 中南大学湘雅三医院骨科,湖南省长沙市  410013
  • 收稿日期:2011-04-11 修回日期:2011-06-21 出版日期:2011-09-24
  • 作者简介:苗惊雷★,男,1977年生,河南省濮阳市人,2003年中南大学毕业,硕士,主治医师,主要从事脊柱外科方面的研究。 miaojinglei@126.com

Cause analysis of Cage displacement after posterior lumber interbody fusion

Miao Jing-lei, Zhang Chao-yue, Zhan Rui-sen, Li Zhi-yue, Liu Zhen-dong   

  1. Department of Orthopaedics, the Third Xiangya Hospital of Central South University, Changsha  410013, Hunan Province, China
  • Received:2011-04-11 Revised:2011-06-21 Online:2011-09-24
  • About author:Miao Jing-lei★, Master, Attending physician, Department of Orthopaedics, the Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China miaojinglei@126.com

摘要:

背景:多数情况下行后路腰椎椎间融合患者发生Cage移位需再次手术翻修,但翻修手术难度大,效果也常不确切。
目的:分析影响后路腰椎椎间融合后Cage移位的相关因素。
方法:回顾性分析中南大学湘雅三医院2004-01/2010-01进行后路腰椎椎间融后发生Cage移位的16例患者及由外院转入的4例同类患者的临床资料,观测病变节段内置入Cage的数目、Cage的置入深度、Cage与椎体终板贴合程度、椎弓根钉系统的稳定性及病变节段椎间隙高度恢复情况等指标。
结果与结论:病变节段使用单枚Cage融合9例,使用双Cage融合11例。Cage置入深度不足者12例,Cage与椎体终板贴合不佳者10例、病变节段椎间隙高度未恢复者8例,椎弓根钉置入位置错误者2例,椎弓根钉螺帽松动者4例。结果说明 Cage的设计、选择、初始置入位置,椎间隙高度的恢复及配合应用椎弓根钉系统的情况可能影响Cage在宿主体内的稳定性。

关键词: 腰椎, 脊柱融合术, 椎间融合器, 内固定器, 植入体

Abstract:

BACKGROUND: Cage displacement is a serious complication after posterior lumber interbody fusion, which often requires reoperation. However, revision surgery is difficult and its effect is uncertain.
OBJECTIVE: To analyze and summarize the correlation factors affecting the displacement of Cage.
METHODS: A retrospective analysis was conducted in 16 cases of Cage displacement in the Third Xiangya Hospital of Central South University and 4 cases from other hospitals between January 2004 and January 2010. We observed and measured the following indexes: the number and depth of implanted Cage, the fitness of Cage and vertebral endplate, the fastness of the pedicle screw system and the hight of intervertebral space.
RESULTS AND CONCLUSION: Single cage was used in lumbar interbody fusion in 9 patients, and other 11 cases were implanted double cages. Insufficient depth of implanted cage was found in 12 patients and unfitness of cage and vertebral endplate was found in 10 patients. Eight cases had the problem of insufficient recovery of the lesion intervertebral height. Pedicle screw fixation was wrong in location in 2 patients, and loosed in 6 patients. Some aspects relating to internal implants, such as design and choice of cage, and the depth of implantation of cage, as well as the fastness of the pedicle screw system, may have effects on the stability of cage.

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