PDF(Pubmed)
Abstract：
Pneumothorax is a rare surgical complication in spinal surgery with thoracic pedicle screws. The penetrating endplate screw (PES) technique has been developed as a strong alternative spinal anchor to conventional pedicle screws for diffuse idiopathic skeletal hyperostosis (DISH). We present an intraoperative pneumothorax without deviation to the thoracic during the maneuver of the PES. A 56-year-old male who presented with non-union of DISH-related T12 vertebral fracture underwent T12 kyphoplasty and T10-L2 posterior fixation using the PES technique. The left pneumothorax was developed postoperatively without screw deviation to the thorax throughout screw insertion. Postoperative CT suggested that a displaced rib head by the lateral misposition of the screw at the inserting point and the pedicle level might injure the pleura. Spine surgeons should know that the lateral insertion of PES has a potential risk for pneumothorax by the displacement of the rib head because of screw trajectory from caudal to cranial apart from conventional pedicle screw.
摘要：
气胸是胸椎椎弓根螺钉脊柱手术中罕见的手术并发症。穿透性终板螺钉（PES）技术已被开发为常规椎弓根螺钉的强大替代脊柱锚钉，用于弥漫性特发性骨骼肥大（DISH）。我们提出了一种术中气胸，在PES的操作过程中没有偏离胸部。一名56岁的男性患有DISH相关的T12椎体骨折不愈合，使用PES技术接受了T12椎体后凸成形术和T10-L2后路固定。左气胸是术后发展的，在整个螺钉插入过程中，螺钉均未偏离胸部。术后CT提示，由于螺钉在插入点和椎弓根水平的横向错位，肋骨头部移位可能会损伤胸膜。脊柱外科医生应该知道，除了常规的椎弓根螺钉外，由于从尾到颅的螺钉轨迹，由于肋骨头移位，PES的侧向插入具有气胸的潜在风险。
