Một số yếu tố liên quan đến thất bại dụng cụ khi sử dụng cấu hình ngắn trong phẫu thuật điều trị chấn thương cột sống Denis IIB vùng ngực thắt lưng

Abstract

Objective: To investigate the related factors for hardware failure of short segment screw fixation with transforaminal interbody fusion in treatment of unstable thoracolumbar burst fracture Denis IIB. Subject and method: A retrospective study was performed in the patients with isolated unstable thoracolumbar burst fractures treated by posterior short segment pedicle screw fixation and transforaminal thoracolumbar interbody fusion from January 2013 to January 2017. All patients were followed up for a minimum of 1 year. Hardware failure was assessed on radiological images at the last follow-up and was defined as a correction loss of more than 10° of the RA values at the final follow-up compared to the immediate postoperative period and/or pedicle screw(s) and/or rod(s) breakage. Demographic data, loss of anterior vertebral body heights, vertebral sagittal and regional sagittal angle were analysed at preoperative, and at last follow up. The hardware failures were recorded and was investigated the relationship with age, sex, LSC, the parameters of pre-operative spinal deformity. Result: There were 36 patients who met the inclusion and exclusion criteria with a mean follow-up duration of 53.3 months (range, from 17 to 73 months). The prevalance of hardware failure was 16.7%, there was no correlation between hardware failure with age and the parameters of spinal deformity, regardless male group had more hardware failures than female group with significant difference. Conclusion: It was not found the correlation between hardware failure and age, the parameters of spinal deformity with exception of sex and time of returning to work after surgery. The incidence of implant failure after using short segment pedicle screw fixation with transforaminal interbody fusion for treatment of thoracolumbar burst fracture was 16.7%.