摘要
目的 探讨使用透视下进行腰椎椎弓钉内固定改良术的经验及其优缺点。方法 总结2000～2004年我科进行腰椎椎弓钉内固定术169例，术中均使用2mm定位克氏针定位，C臂x-光机透视调整定位针至满意后再用自行设计的空心丝攻准备孔道，共置入椎弓根螺钉776枚。结果 776枚螺钉中有758枚位置正确，18枚存在不同程度的偏差，成功率为97．6％。术后3个月和6个月的随诊腰椎曲度和固定节段椎体高度维持。没有出现内固定松脱，螺钉断裂等情况。结论 改良的腰椎椎弓根内固定术具有术中可反复调整人钉的位置及角度、提高钉道的准确性、减轻对椎弓根的破坏、大大提高植入物的稳固性的优点。
Objective To explore the clinical experiences and characteristics of internal fixation reformed reconstruction surgery applied to lumbar pedicle of vertebral arch under radiological guidance. Metheds Kirschner wires were used to find the position, X- ray was used to adjust the appropriate position of the metal pin, hollow threads designed by ourselves were used in preparation of the hole, and 776 pedicle of vertebral arch screws were placed, which were reviewed during the period from 2000 through 2004. Results It was observed that： 7.58 screws were put in position, 18 screws showed a little deflection, and 9？. 6% was satisfactory. Only one case occurred transitory symptoms related nerve root because of too inboard deflection, 5 screws drilled through the cortical layer and positioned in the intervertebral space. Others showed that lumbar camber and highness of vertebra were well maintained, and no fixation materials dropped out or screws cracked during a 3 - or 6 - month postoperative follow up. Conclusions Reformative reconstruction operation of internal fixation for lumbar pedicle of vertebral arch shows many merits throughout the operation, such as screws＇ position can be adjusted repeatedly, the veracity of the hole of screws has been improved, damage for pedicle decreased, and stability of fixation materials reformed.
出处
《实用预防医学》
CAS
2006年第3期727-728,共2页
Practical Preventive Medicine
关键词
腰椎
椎弓根螺钉
内固定改良术
Lumbar vertebrae
Pedicle of vertebral arch screws
Internal fixation
Improved operation
