摘要
目的探讨椎弓根螺钉参数对腰椎退行性疾病患者术后螺钉松动率的影响。方法选择2017年1月~2022年6月在本院接受腰椎减压、植骨融合内固定手术治疗的157例退行性腰椎疾病患者作为研究对象,观察椎弓根螺钉型号[锥形芯/螺纹(A型)、圆柱形芯/螺纹(B型)、圆柱形螺纹/锥形芯(C型)]、螺纹内外径、螺距、螺纹类型等参数与术后18个月时螺钉松动的关系。结果随访至18个月时,共有55例患者出现椎弓根螺钉松动的CT征象。使用最多的为A型、外径6.0 mm、内径4.5 mm、螺距2.5 mm、螺纹类型为V型的椎弓根螺钉(28.03%),其次为A型、外径6.0 mm、内径4.0 mm、螺纹V型(27.39%)和C型、外径6.5 mm、内径4.0 mm、螺距2.5 mm、螺纹类型为锯齿形(22.93%)的螺钉。单因素和多因素Logsitic回归分析显示,融合节段数、螺纹最大内径、螺距是螺钉松动的风险因素(P<0.05),螺纹最大外径、骨密度是螺钉松动的保护性因素(P<0.05)。结论椎弓根螺钉螺距和螺纹内外直径会影响术后螺钉松动率,螺钉几何形状和螺纹类型可能对椎弓根螺钉松动可能无显著影响。
Objective To investigate the effect of pedicle screw parameters on the loosening rate of patients with lumbar degenerative diseases.Methods A total of 157 patients with degenerative lumbar diseases treated with internal fixation in our hospital from January 2017 to June 2022 were selected as the research object.The relationship between the type of pedicle screw[conical core/thread(type A),cylindrical core/thread(type B),cylindrical thread/conical core(type C)],the internal and external diameter of thread,pitch and thread type of thread and the loosening of pedicle screw at 18 months was observed.Results After follow-up to 18 months,55 patients had CT signs of pedicle screw loosening.The most commonly used were type A[pedicle screws with outer diameter of 6.0 mm,inner diameter of 4.5 mm,pitch of 2.5 mm and thread type of V(28.03%)],followed by type A[outer diameter of 6.0 mm,inner diameter of 4.0 mm,pitch of V(27.39%)]and type C[outer diameter of 6.5 mm,inner diameter of 4.0 mm,pitch of 2.5 mm and thread type of serrated(22.93%)].Univariate and multivariate Logsitic analysis showed that the number of fusion segments,the maximum inner diameter and pitch of thread were the risk factors of screw loosening(P<0.05),and the maximum outer diameter and radial bone mineral density of thread were the protective factors of screw loosening(P<0.05).Conclusion The screw pitch and internal and external thread diameter of pedicle screw can affect the loosening rate of pedicle screw,and the screw geometry and thread type may have no significant effect on the loosening of pedicle screw.
作者
王新茂
刘伟强
刘会英
刘冬冬
WANG Xin-mao;LIU Wei-qiang;LIU Hui-ying;LIU Dong-dong(Zhengzhou Renji Hospital Surgery,Zhengzhou,Henan 450000,China)
出处
《颈腰痛杂志》
2023年第6期986-989,共4页
The Journal of Cervicodynia and Lumbodynia
关键词
腰椎退行性疾病
椎弓根螺钉
螺钉松动
内固定
lumbar degenerative disease
pedicle screw
pedicle screw loosening
influence
作者简介
王新茂(1975-),男,河南籍,主治医师。
