Analysis of the failed internal fixations for thoracolumbar fractures / 中华创伤骨科杂志

ABSTRACT

Objective To discuss the common causes for postoperative complications after treatment of spinal fractures and their preventive measures.Methods To analyze the 32 failed eases who received internal fixation for their thoracolumbar fractures between July 1998 and April 2005 in our department.Their preoperative and postoperative results of X-ray,CT and MIR examinations were reviewed to find out the causes for failure.Three of them were treated through anterior approach and 29 through posterior approach.Eighteen screws broke in eight eases, the rods got loosened in eight cases and broken in four cases,15 pedicte screws were mis-located in eight cases and the implants got loosened in three cases.Results Thirty patients had to get a reoperation.Two were cured through non-surgical treatment.The causes for failure were found to be as follows1,incorrect operation approach;2,in- stability of the front-middle colunm;3,unskillful operation;4,ignorance or the lesion to the adjacent vertebral discs; 5,flaws in pedicle screw design.Conclusion To prevent postoperative complications after internal fixation for spinal fractures,surgeons should strictly stick to the indications before operation,choose a proper approach and method for internal fixation,try to stabilize the front-middle column by the first intention,and have a good command of anatomy and operation skills.