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徒手个体化下颈椎椎弓根螺钉置入技术的解剖学研究 被引量:3

Individual Free-Hand Cervical Pedicle Screw Placement:An Anatomical Study
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摘要 目的探索一种新的安全、可靠、实用的颈椎弓根螺钉置钉方法。方法成人全颈椎标本共5具,分别行薄层三维CT检查,并对图像进行分析、测量,确定C3—C7每个椎体椎弓根在椎板上的投影点及椎弓根的角度、深度;采用改良的Abumi椎弓根螺钉置入技术置入颈椎椎弓根螺钉;将置钉后全颈椎标本再行三维CT检查及大体解剖观察。结果共置入50枚螺钉,其中优39枚,良6枚,差5枚,优秀率78%,成功率90%。失败的5枚中,外侧壁破裂4枚,下侧壁破裂1枚。结论采用个体化改良的Abumi椎弓根螺钉置入技术在C3-7节段进行徒手个体化置钉相对安全、可靠,可考虑在临床推广应用。 Objective To explore a safe,reliable and practical method for cervical pedicle screw placement. Methods Thin-section three-dimensional CT scans of cervical spines (C3-7) of 5 adult cadavers were performed and CT images were analyzed and determined to confirm the projection of pedicles and the angle and depth of pedicle screw placement. Pedicle screws were placed using the improved Abumi technique. The accuracy of pedicle screw placement was evaluated by CT scan and gross anatomical observation. Results A total of 50 pedicle screws were placed in the lower cervical spine. Among these screws, results were excellent in 39,good in 6 and poor in 5. The excellent rate and success rate were 78% and 90% ,respectively. Among the 5 failed pedicle screws,lateral wall rupture occurred in 4 and inferolateral wall rupture in 1. Conclusion The individual free-hand pedicle screw placement in the lower cervical spine is relatively safe and reliable and should be popularized in clinical application.
出处 《南昌大学学报(医学版)》 CAS 2013年第11期15-17,共3页 Journal of Nanchang University:Medical Sciences
基金 江西省卫生厅普通科技计划(20123027)
关键词 徒手 个体化 下颈椎 椎弓根螺钉 解剖 free-hand individuation lower cervical spine pedicle screw anatomy
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参考文献5

  • 1Jones E L,Heller J G,Silcox D H,et al.Cervical pedicle screws velsus lateral mass screws:anatomic feasibility and biomechanical comparison[J].Spine,1997,22:977-982.
  • 2Barnes A H,Eguizabal J A,Acosta F L J r,et al.Biomechanical pull out strength and stability of the cervical artificial pedicle screw[J].Spine,2009,34:16-20.
  • 3Abumi K,Shono Y,Kotani Y,et al.Indirect Posterior reduction and fusion of the traumatic herniated disc by using a cervical Pedicle screw system[J].Neurosurg,2000,92:30-37.
  • 4Kotani Y,Cunningham B W,Abumi K,et al.Biomechanical analysis of cervical stabilization system[J].Spine,1994,19:2529-2539.
  • 5Miller R M,Ebraheim N A,Xu R M,et al.Anatomis consideration of transpedicalar screw placement in the cervical spine.An analysis of two approaches[J].Spine,1996,21:2317-2322.

同被引文献21

  • 1解京明,张漾杰,王迎松,张颖,鲁宁.颈椎弓根螺钉内固定在下颈椎骨折中的应用[J].中华创伤骨科杂志,2007,9(5):497-498. 被引量:12
  • 2刘观燚,徐荣明,马维虎,阮永平,孙韶华,黄雷,应江炜,蒋伟宇.下颈椎经关节突关节椎弓根螺钉固定的可行性[J].中国脊柱脊髓杂志,2007,17(7):539-542. 被引量:7
  • 3Abumi K,Shono Y,Kotani Y,et al.Indirect posterior reduction and fusion of the traumatic herniated disc by using a cervical pedicle screw system[J].Neurosurg,2000,92:30-37.
  • 4Jones E L,Heller J G,Silcox D H,et al.Cervical pedicle screws velaus lateral mass screws:anatomic feasibility and biomechanical comparison[J].Spine,1997,22(9):977-982.
  • 5Barnes A H,Eguizabal J A,Acosta F L Jr,et al.Biomechanical pull out strength and stability of the cervical artificial pedicle screw[J].Spine,2009,34 (1):16-20.
  • 6Kotani Y,Cunningham B W,Abumi K,et al.Biomechanical analysis of cervical stabilization system[J].Spine,1994,19 (22):2529-2539.
  • 7Ludwig S C,Kramer D L,Vaeearo A R,et al.Trans-pedicle screw fixation of the cervical spine[J].Clin Orthop Relat Res,1999,359:77-88.
  • 8Miller R M,Ebraheim N A,Xu R M,et al.Anatomis consideration of transpedicalar screw placement in the cervical spine.An analysis of two approaches[J].Spine,1996,21 (23):2317-2322.
  • 9贾卫斗,贾薇薇,杨飞,杨博贵,郑铁钢,许英杰,云得才,孙华.颈椎椎弓根技术在下颈椎疾患应用的临床疗效观察[J].中国矫形外科杂志,2010,18(6):457-460. 被引量:8
  • 10尹华,赵银必.三种置钉方法在下颈椎经椎弓根螺钉置入过程中的比较[J].中国组织工程研究与临床康复,2011,15(22):4040-4045. 被引量:7

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