颈椎前路带锁钢板植入不当并发症及预防  

The Complication and Prevention in the Inappropriate Insertion of Anterior Cervical Vertebra Locking Plate

作　　者：杨进顺[1] 黄文铎[1] 

机构地区：[1]广州医学院第二附属医院骨外科,广东广州510260

出　　处：《广州医学院学报》2004年第1期43-45,共3页Academic Journal of Guangzhou Medical College

摘　　要：目的 :探讨颈椎前路带锁钢板植入不当并发症及其预防措施。方法 :回顾我院自 1995以来采用前路带锁钢板固定治疗 ,随访资料完整的颈椎疾患 12 1例 ,经平均随访 18个月 ,其中 18例发生植入不当并发症 ,并对其发生的原因及预防措施进行分析。结果 :发生钢板植入偏斜 9例 ,螺钉进入椎间隙 2例 ,钢板未完全锁定 5例 ,其中高出钢板平面 1～ 2mm 2例 ,2～ 3mm 2例 ,4mm 1例 ,发生螺钉松动并滑脱 2例 ,但无导致食道瘘等。本组未出现钢板螺钉断裂。结论 :颈椎前路带锁钢板植入不当并发症的发生大多与术前病例头颈摆放偏侧或族转 ,手术视野暴露不充分 ,螺钉锁定不完全 ,螺钉进入椎间隙等因素有关。Objective:To discuss on complication and preventive methods in the inappropriate insertion of anterior cervical vertebra locking plate. Methods: 121 cases inserted with anterior cervical vertebra locking plate for cervical spine immobilization treatment at our hospital since 1995 were reviewed and followed up. The average follow up period was 18 months. 18 cases were found to have complications due to inappropriate insertion. The causes of complication were analyzed and the prevention of complications was discussed. Results: The plate was deviated in 9 cases. Screw was inserted into intervertebral space in 2 cases. Plate was not secured completely in 5 cases. Screw was found to be exceeding surface of the plate 1～2 mm in 2cases, 2～3 mm in 2 cases and 4mm in 1 case. In addition, screw loosened and slid off in 2 cases. However, no esophageal fistula was identified. No plate or screw was found broken in this group. Conclusions: The complications due to inappropriate insertion of anterior cervical vertebra locking plate are mainly related to the practical experiences of the operating surgeon. Being adequately familiar with the neck anatomy and having meticulous operating skills are the keys in preventing the complications.

关 键 词：颈椎带锁钢板 内固定 并发症 

分 类 号：R687.32[医药卫生—骨科学]