骶2髂骨三皮质螺钉和髂骨螺钉的临床并发症比较  

Comparison of clinical complications of iliac screw fixation versus S2 alar-iliac screw

作　　者：谢雁春 王丹妮[1] 吴骏[1] 轩安武 李卓[1] 于海龙[1] XIE Yan-chun WANG Dan-ni WU Jun XUAN An-wu LI Zhuo YU Hai-long(Spinal Ward of Orthopaedics Departement, General Hospital of Shenyang Military Region, Shenyang Liaoning 110016, China)

机构地区：[1]沈阳军区总医院骨科脊柱病区,辽宁沈阳110016

出　　处：《局解手术学杂志》2017年第6期415-418,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：辽宁省科技攻关基金(2012225019)

摘　　要：目的比较分析骶2髂骨三皮质螺钉(S2AI)和髂骨螺钉(IS)内固定技术的临床并发症。方法回顾性分析2010年8月至2012年7月我院接受脊柱骨盆内固定术的65例退行性脊柱侧凸患者的临床资料,根据脊柱骨盆内固定方式将其分为髂骨螺钉组(IS组)43例和骶2髂骨三皮质螺钉组(S2AI组)22例,记录并分析2组病例内固定物松动、折断、急性切口感染、迟发性切口并发症以及臀部超过3个月的持续性疼痛等早期临床并发症。结果 IS组有8例螺钉松动、13例迟发性臀区疼痛,S2AI组无螺钉松动、2例迟发性臀区疼痛,IS组和S2AI组术后迟发性臀部疼痛的平均起病时间分别为11.8个月和18个月,S2AI组(18.6%)相比于IS组(21.1%)在术后螺钉松动方面和迟发性疼痛方面的绝对风险值降低。IS组有5例迟发性切口感染,其中3例经过清创及冲洗后治愈,2例清创冲洗后同时取出内植物;S2AI组无迟发性切口感染病例。结论 S2AI临床并发症明显少于IS,是一种被值得推广的脊柱骨盆内固定技术。Objective To compare the clinical complications between S2 alar-iliac（S2AI） screw and iliac screw（IS） fixation technique. Methods The data of 65 patients who were diagnosed as degenerative scoliosis and underwent spinopelvic fixation in our hospital from Au- gust 2010 to July 2012 were retrospectively reviewed. These patients were divided into the iliac screw fixation group （ IS group） with 43 pa- tients and the S2 Mar iliae fixation group （S2AI group） with 22 patients according to different methods. The complications included screw loosening, screw breakage, acute infections, delayed wound infection and persistent pain over the gluteal region occurring longer than 3 months postoperatively were recorded. Results There were 8 cases with screw loosening and 13 cases with gluteal pain in IS group ,while there were no screw loosening and only 2 cases with gluteal pain in S2AI group. The average onset of gluteal pain were 11.8 months postoperatively in the IS group and 18 months postoperatively in the S2AI group. It showed that the absolute risk reduction（ARR） of screw loosening and late pain in the S2AI group was 18.6% ,which was lower than 21. lifo in the IS group. In the IS group, there were a total of 5 cases of delayed wound infection. Finally ,3 caes of them were cured by irrigation and debridement only. and the other 2 cases were cured by irrigation and de- bridement with implant removal. There were no cases of delayed wound infection in the S2AI group. Conclusion The S2AI technique is asso- ciated with significantly less clinical and radiographic complications when compared with the iliac screws technique,it is a kind of internal fix- ation of spine and pelvis, which is worthy of being popularized by spine surgeons.

关 键 词：骶2髂骨三皮质螺钉 髂骨螺钉 脊柱骨盆 骶骨骨盆 内固定术 并发症 

分 类 号：R445.4[医药卫生—影像医学与核医学]