The Analysis And Preventive Measures Of Clincal Results Caused By The Misplacement Of Pedicle Screw

Objective: Analyse the clinical results of the pedicle screw misplacement, study thepreventive measures of pedicle screw misplacement, avoid various clinical complicationswhich caused by pedicle screw misplacement as much as possible, in order to improve theoperation curative effect of pedicle internal fixation.Methods: Select the patients of the first hospital of Shandong University ofTraditional Chinese Medicine spinal Orthopaedics and the second hospital of ShandongUniversity of Traditional Chinese Medicine spinal Orthopaedics from July2009to July2011,and confirmed by imaging,14patients with misplacement in thoracic and lumbarspine pedicle screw was treated in Department of Orthopaedics, and we put them intogroup A;83patients with correct position in the thoracic and lumbar pedicle screw wereput into group B, the patients of the two groups were97in all. Through the postoperativeradiographs, obverse the situation of pedicle screw misplacement of group A, and regularpostoperative follow-up.Gather the VAS pain score and other related data of the twogroups of patients before and after the operation. Use the relevant software to make aretrospective analysis.Results:97patients were followed up by1,3,6, and12months. We discover thescrew through the medial pedicle cortex in2cases, through the lateral pedicle cortex in4cases, screw placement in too deep in2cases, screws into the intervertebral space in6cases of group A, VAS scores of preoperative are7.19±0.789, VAS scores of postoperativeare3.83±0.459; VAS scores of preoperative are7.19±0.734, VAS scores of postoperativeare2.09±0.483of group B. The frequency of various clinical complications is higher ingroup A than group B.Conclusion: Pedicle screw misplacement has a great influence on patients, increase the suffering of the patients, bring the medical disputes which are difficult to deal with, weshould avoid pedicle screw misplacement in the clinical work as possible as we can. Theimproper reasons of pedicle screw placement are related to the operation of physicians onthe local anatomic variation, the operation stage positioning and operation processoperation skills. Operation doctors read the radiograph carefully before operating, and theyare familiar with the pedicle anatomy. They should operate standardly while operating andchoose the right screw entrance point, and master the correct placement technique. Monitorthe whole process of surgery for screw placement with positive and lateral radiographs. Inthis way we can improve the accuracy of screw placement. The key to correct placement isimproving the operation skills, lateral fluoroscopy in the operation, observing the distanceof the screw with upper edge, lower edge and vertebral frontal cortex. The doctor shouldpay attention to normal position fluoroscopy of the screw. They should observe whetherthe screw is in the pedicle of vertebral arch, whether it is on the side, offset, partial internalor partial outer.