对使用骨水泥增强的脊柱器械救治进行长期跟踪。

F Polinelli, M Pileggi, I Cabrilo, C Commodaro, S M J van Kuijk, A Cardia, A Cianfoni
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引用次数: 0

摘要

背景和目的:据报道,经皮骨水泥植入术是一种有效的抢救方法,适用于脊柱器械失效的体弱患者,如螺钉松动、硬件断裂、骨笼下陷以及稳定节段内或邻近节段的骨折。一项对29名患者的31次连续手术进行的回顾性分析显示,在16个月的中位随访期内,手术效果良好。本研究报告了该疗法在避免或推迟翻修手术方面的长期有效性:我们回顾性地收集并审查了原有患者群的临床和放射学数据,以提供扩展的随访评估。评估的主要结果是是否需要进行脊柱翻修手术,次要结果是增强脊柱植入物的放射学稳定性:结果:27/29 例患者接受了延长的放射学随访,平均随访时间为 50.9 个月。总体而言,18/27(66.7%)名原本需要接受翻修手术的患者在接受了骨水泥增强救助手术后避免了手术干预。其余患者的骨水泥植入抢救和翻修手术之间的平均间隔时间为 22.5 个月。2/27(7.4%)例患者发生了种植体移动,1/27(3.7%)例患者发生了杆折断,4/27(14.8%)例患者发生了器械节段内或邻近节段的新骨折,5/27(18.5%)例患者发生了抢救水平的螺钉松动:结论:在这批患者中,骨水泥增强救治术可有效避免或推迟长期随访中的翻修手术:缩写:不适用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
An Extended Follow-up of Spinal Instrumentation Rescue with Cement Augmentation.

Background and purpose: Percutaneous cement augmentation has been reported as an effective salvage procedure for frail patients with spinal instrumentation failure, such as screw loosening, hardware breakage, cage subsidence, and fractures within or adjacent to stabilized segments. Favorable results were reported during a median follow-up period of 16 months in a retrospective analysis of 31 consecutive procedures performed in 29 patients. In the present study, the long-term effectiveness of this treatment in avoiding or postponing revision surgery is reported.

Materials and methods: Clinical and radiologic data of our original cohort of patients were retrospectively collected and reviewed to provide an extended follow-up assessment. The need for revision spinal surgery was assessed as the primary outcome, and the radiologic stability of the augmented spinal implants was considered as the secondary outcome.

Results: An extended radiologic follow-up was available in 27/29 patients with an average of 50.9 months. Overall, 18 of 27 (66.7%) patients, originally candidates for revision surgery, avoided a surgical intervention after a cement augmentation rescue procedure. In the remaining patients, the average interval between the rescue cement augmentation and the revision surgery was 22.5 months. Implant mobilization occurred in 2/27 (7.4%) patients; rod breakage, in 1/27 (3.7%); a new fracture within or adjacent to the instrumented segment occurred in 4/27 (14.8%) patients; and screw loosening at rescued levels occurred in 5/27 (18.5%) patients.

Conclusions: In this cohort, cement augmentation rescue procedures were found to be effective in avoiding or postponing revision surgery during long-term follow-up.

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