IMMEDIATE COMPLICATIONS OF COTREL-DUBOUSSET INSTRUMENTATION TO THE SACRO-PELVIS - A CLINICAL AND BIOMECHANICAL STUDY
IMMEDIATE COMPLICATIONS OF COTREL-DUBOUSSET INSTRUMENTATION TO THE SACRO-PELVIS - A CLINICAL AND BIOMECHANICAL STUDY
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DOI：
10.1097/00007632-199009000-00018
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发表时间：
1990-09-01
期刊：
影响因子：
3
通讯作者：
ROACH, J
中科院分区：
文献类型：
--
作者：
CAMP, JF;CAUDLE, R;ROACH, J
作者回顾了在德克萨斯苏格兰Rite医院使用Cotrel-Dubousset器械融合骶盆的所有患者的早期并发症。研究了16例患者，平均随访13个月。评价了三种骶盆固定方法：髂骶螺钉、骶骨螺钉和一种技术，即采用加尔维斯顿技术将Cotrel-Dubousset棒的尾端成型并插入后髂嵴。16组骶骨螺钉中有7组（44%）在术中和术后失效。7组髂骶螺钉中有2组在术后失效（28%）。采用加尔维斯顿技术放置的8套Cotrel-Dubousset棒未发生失效。观察到的9例医疗并发症中有7例（77%）发生在骶骨螺钉组。使用小牛脊柱，对每个系统进行生物力学评价，以确定固定强度。每个系统屈曲失败3次。骶骨螺钉最弱，在40 NM处直接从骶骨中拔出。采用加尔维斯顿技术插入的Cotrel-Dubousset棒最强，在70 NM屈曲失效前发生棒变形。髂骶螺钉为中等强度螺钉，在55 NM处沿螺钉轴旋转或直接从髂骨中拔出时失效。作者得出结论，使用Cotrel-Dubousset棒插入加尔维斯顿技术是三种测试方法中最强和最安全的骶骨骨盆固定方法
The authors reviewed the early complications in all patients fused to the sacro-pelvis using Cotrel-Dubousset instrumentation at the Texas Scottish Rite Hospital. Sixteen patients were studied with an average follow-up of 13 months. Three methods of sacro-pelvis fixation were evaluated: iliosacral screws, sacral screws, and a technique whereby the caudle ends of the Cotrel-Dubousset rods were fashioned and inserted into the posterior iliac crest using the Galveston technique. Seven of the 16 sets of sacral screws (44%) failed during and after surgery. Two of the 7 sets of iliosacral screws failed postoperatively (28%). No failures occurred in the 8 sets of Cotrel-Dubousset rods placed with the Galveston technique. Seven of the nine medical complications observed (77%) occurred in the sacral screw group. Using calf spines, a biomechanical evaluation of each system was undertaken to determine strength of fixation. Each system was failed in flexion 3 times. The sacral screws were the weakest, pulling directly out of the sacrum at 40 NM. Cotrel-Dubousset rods inserted with the Galveston technique were the strongest, experiencing rod deformities before flexion failure at 70 NM. Iliosacral screws were of intermediate strength failing by rotation on the axis of the screws or pulling directly out of the ilium at 55 NM. The authors conclude that using Cotrel-Dubousset rods inserted with the Galveston techniques was the strongest and safest method of sacro-pelvis fixation of the three tested