非影像监视下行脊柱侧凸胸椎椎弓根螺钉置入的临床应用  

Clinical application of free hand placement of pedicle screws in thoracic spine scoliosis

作　　者：刘一[1] 齐欣[1] 张绍昆[1] 苗巍巍[1] 宋之明[1] 

机构地区：[1]吉林大学第一临床医院骨科,吉林省长春市新民大街1号130021

出　　处：《中国脊柱脊髓杂志》2005年第4期225-228,共4页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:探讨脊柱侧凸胸椎椎弓根螺钉非影像监视下徒手置入的方法及可行性。方法:57例脊柱侧凸患者行后路椎弓根螺钉系统矫形手术,徒手法置入胸椎椎弓根螺钉。术后常规拍摄脊柱全长X线片,随机选取10例患者行CT扫描观察,了解螺钉置入的准确性。结果:共置入胸椎椎弓根螺钉362枚。术后X线片观察到10枚螺钉偏外,4枚螺钉偏下,其中2枚螺钉引起轻微肋间神经痛,3周后完全缓解。CT观察47枚螺钉有2枚螺钉导致椎弓根内壁膨胀内移,没有相应神经症状。主弯Cobb角术前平均60.4°(32°～121°),术后平均18.3°(1°～70°),平均矫正率71.9%(38.1%～98.0%)。结论:徒手法置入脊柱侧凸胸椎椎弓根螺钉是可行的。Objective:To study the procedure of free hand pedicle screw placement in thoracic spine scoliosis.Method:57 cases were included to study the protocol of the procedure,the technique details were elucidated.The accuracy of screw placement was evaluated with X ray in all cases and CT in 10 cases of the group.Result:Curves were corrected with satisfaction.A total number of 362 screws were placed.Medial wall migrated of the pedicle was revealed with 2 screws in 2 patients,but non-permanent neural damage was observed.Conclusion:Free hand placement of pedicle screws in thoracic spine scoliosis is a clinical feasible and recommended procedure.

关 键 词：胸椎 脊柱侧凸 椎弓根螺钉 

分 类 号：R682.3[医药卫生—骨科学]