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척추경 나사못 내고정기기를 이용한 척추질환의 치료시 발생되는 합병증
신병준,노영복,서유성,이병일,김연일,나수균,최창욱 대한척추외과학회 1994 대한척추외과학회지 Vol.1 No.2
The concept of pedicle screw fixation opened a new horizon of spinal surgery by providing rigid fixation of spine. But it is technically a demanding procedure which could produce lots of complications including general complications, hardware problems, technical problems and long term changes of junctional motion segments. The purpose of this paper is to analyse the complications and problems developed during and after pedicle screw fixation for various spinal disorders and tarumas. Hundred and four patients were treated by pedicle screw fixation during the 3 year period from June 1988 to June 1991, and 73 patients were followed more than 18 months. Average follow-up was 26.5 months. Threr were 44 degenerative conditions, 24 frac- tures and 5 moscellaneous disorder. Fixation segments were single in 25, two levels in 36 and more than three levels in 12. Total number of screw used were 392. Posterior fusion was done in 7, posterolateral in 36, combined A+P fusion in 11 and PLIF in 19. CDI was used in 69, Steffee plate in 3 and Diapason in 1. All the surgeries were done by one surgeon. The results were as follows: 1.94 complications were noted in 46 patients out of 73 patients(63%) studied. 2.Most complications did not show poor clinical progress except one case of dedp would infection which needed removal of hardware, one case of persistent CSF leakage and one case of thigh pain due to degeneration of upper junctional motion segment. 3.Usually more than two complications were noted in each patient. In conclusion, pedicle screw fixation itself is a nice procedure to treat many kinds of spinal problems but it also produces variable complications. So, we should always be careful to per- form precise procedure to prevent those problems. Complications could be prevented by precise diagnosis before the operation, correction of predisposing factors during the operation and care- ful postoperative care.