后路脊柱器械融合术后骶骨骨折的症状:一个病例系列。

IF 1.5 4区 医学 Q3 ORTHOPEDICS
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引用次数: 0

摘要

背景:脊柱融合装置和技术的改进使脊柱融合更加牢固,取得了良好的临床效果。然而,可能会出现与植入物相关的并发症,如螺钉错位、螺钉润滑、椎间盘脱位和皮肤问题。本研究旨在探讨脊柱器械融合术后骶骨骨折的特点和症状。方法:本病例系列回顾性分析了2015年2月至2022年3月期间8名患者(1男7女;平均年龄:74岁)在接受后路脊柱融合术后诊断为骶骨骨折的医疗记录。结果:所有患者的平均融合水平为3.5(范围1-10)。最低的器械椎骨(LIV)从L5到髂骨。术后18.8个月(0.5-84个月)诊断为骶部骨折。从咨询到诊断的平均时间为9天(0-25天)。两名患者有亚临床骨折,两名患者在L5处有H型骨折,四名患者有U型骨折,包括螺钉孔。臀部疼痛和下肢疼痛是最常见的症状,各有7名患者出现。还有可能与L5或S1神经根病有关的腿部麻木、肌肉无力和单侧腿部疼痛。在所有患者中,腿部和臀部疼痛在运动和坐姿时更严重,在休息和仰卧位时更好。三名患者接受保守治疗,五名患者接受髂骨延长固定治疗。结论:脊柱融合术后骶部骨折可引起神经根病和臀部疼痛。当骨盆区域出现不稳定时,例如在运动或坐着时,症状尤其严重。由于非典型神经根病可能导致诊断延迟,脊柱外科医生应该认识到这种情况的症状。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Symptoms of sacral fractures after posterior spinal instrumented fusion: A case series

Background

Improvements in spinal fusion devices and techniques have enabled stronger spinal fusion, resulting in excellent clinical outcomes. Nevertheless, complications associated with implants, such as screw misalignment, screw lubrication, cage dislocation, and skin issues, might occur. This study aimed to investigate the characteristics and symptoms of sacral fractures after spinal instrumented fusion.

Methods

This case series retrospectively examined the medical records of eight patients (one man and seven women; mean age: 74 years) diagnosed with sacral fractures after undergoing posterior spinal instrumented fusion from February 2015 to March 2022.

Results

The average number of fusion levels in all patients was 3.5 (range, 1–10). The lowest instrumented vertebrae (LIV) ranged from L5 to the ilium. Sacral fractures were diagnosed at 18.8 (range, 0.5–84) months postoperatively. The average time from consultation to diagnosis was nine days (range, 0–25 days). Two patients had subclinical fractures, two had H-shaped fractures with the LIV at L5, and four had U-shaped fractures, including screw holes. Buttock pain and lower extremity pain, the most commonly reported symptoms, were observed in seven patients each. There were also instances of leg numbness, muscle weakness, and unilateral leg pain that may be related to L5 or S1 radiculopathy. In all patients, leg and buttock pain were worse during movement and in the sitting position, and better while resting and in the supine position. Three patients were treated conservatively, and five were treated with extended fixation to the ilium.

Conclusions

Sacral fractures following posterior spinal fusion can cause radiculopathy and buttock pain. Symptoms are especially severe when instability occurs in the pelvic region, such as during movements or sitting. As atypical radiculopathy may lead to delays in diagnosis, spine surgeons should recognize the symptoms of this condition.

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来源期刊
Journal of Orthopaedic Science
Journal of Orthopaedic Science 医学-整形外科
CiteScore
3.00
自引率
0.00%
发文量
290
审稿时长
90 days
期刊介绍: The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.
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