[1]王丹 蔡贤华△ 蒋欣浩 刘平涛 黄威 袁彪 康辉.腰椎后路椎间融合内固定术后融合器后移处理23例[J].中国中医骨伤科杂志,2021,29(07):68-71.
　WANG Dan CAI Xianhua JIANG Xinhao LIU PingtaoHUANG Wei YUAN Biao KANG Hui.Treatment Strategy of Posterior Cage Migration Following PosteriorLumbar Interbody Fusion:A Report of 23 Cases[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(07):68-71.
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腰椎后路椎间融合内固定术后融合器后移处理23例()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年07期
页码:
68-71
栏目:
临床报道
出版日期:
2021-07-15

文章信息/Info

Title:
Treatment Strategy of Posterior Cage Migration Following PosteriorLumbar Interbody Fusion:A Report of 23 Cases
文章编号:
1005-0205(2021)07-0068-04
作者:
王丹1 蔡贤华1△ 蒋欣浩2 刘平涛2 黄威2 袁彪2 康辉3
1湖北中医药大学(武汉,430065)2荆门市第二人民医院3解放军中部战区总医院骨科
Author(s):
WANG Dan1 CAI Xianhua1△ JIANG Xinhao2 LIU Pingtao2HUANG Wei2 YUAN Biao2 KANG Hui3
1Hubei University of Chinese Medicine, Wuhan 430065,China; 2Jingmen No.2 People’s Hospital, Jingmen 448000, Hubei China; 3Department of Orthopaedics, General Hospital of PLA Central Theater, Wuhan 430070,China.
关键词:
腰椎后路椎间融合术;  融合器;  后移;  翻修术
Keywords:
lumbar interbody fusion;  cage;  migration;  revision
分类号:
R681.5
文献标志码:
B
摘要:
目的:探讨腰椎后路椎间融合内固定术后融合器后移处理策略。方法:选取2012年1月至2018年10月诊治腰椎退行性疾病,行腰椎椎间融合内固定患者692例,其中术后出现融合器后移23例,通过回顾性分析患者临床资料、处理方式、随访结果,探讨发生融合器后移后合适的处理方式。结果:23例融合器后移患者获得随访,随访时间12～75个月,平均21.3个月; 早期移位10例,晚期移位13例; 11例保守治疗,12例行手术翻修; 翻修病例中4例出现硬脊膜破裂,2例出现伤口延迟愈合,1例术后2 a再次出现融合器后移。结论:腰椎后路椎间融合术后融合器后移由多种原因导致,发现融合器后移应积极完善腰椎正侧位片、动力位片、CT三维重建及MRI,评估椎间融合情况及椎管内占位情况,并通过评估对病情进展进行预判,对预估保守治疗效果差、后期风险高的患者应及时进行手术翻修。
Abstract:
To discuss the treatment strategy of posterior cage migration following posterior lumbar interbody fusion.Methods:A total of 692 consecutive patients who underwent lumbar interbody fusion and internal fixation for lumbar spine degenerative disease diagnosed from January 2012 to October 2018 were selected, 23 cases of cage retropulsion.The clinical data, treatment methods, and follow-up results of the patients were retrospectively analyzed to discuss the treatment strategy of cage migration.Results: 23 cases with posterior cage migration were followed up for 12 to 75 months, with an average of 21.3 months.10 cases were displaced in the early stage and 13 cases in the late stage.11 cases were treated conservatively, and 12 cases underwent surgical revision.Among the revision cases, dura tear happened in 4 cases, wound healing delay occurred in 2 cases, and 1 case had a re-migration 2 years after revision.Conclusion: Cage migration following posterior lumbar interbody fusion is often caused by multiple-factors.The relevant imaging data such as lumbar anterior and lateral radiographs, dynamic radiographs, CT three-dimensional reconstruction and MRI should be actively improved once cage migration happens, to evaluate the condition of intervertebral fusion and spinal canal occupation, and predicting the progress of the disease through the evaluation.Patients with poor conservative treatment efficacy and high risk of later stage should be taken a positive attitude and undergo surgical revision in time.

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备注/Memo

备注/Memo:
基金项目:湖北省中医药科研青年人才项目(ZY2021Q009)
△通信作者 E-mail:wgcaixh@163.com
更新日期/Last Update: 2021-07-15