腰椎人字嵴顶点椎弓根螺钉进钉方法的临床应用  

Clinical application of entry point of pedicle screw through the “人” shape crest in lumbar spine

作　　者：成本强[1] 龙朝仪[1] 张爱宁[1] 吴世寨[1] 李海平[1] 

机构地区：[1]广东省肇庆市第一人民医院骨外科,526040

出　　处：《中国医师进修杂志（外科版）》2006年第4期24-26,共3页Chinese Journal of Postgraduates of Medicine

基　　金：肇庆市科技创新计划立项项目(编号:104E212)

摘　　要：目的比较人字嵴顶点进钉点与传统进钉点(Weinstein法)行椎弓根钉内固定的效果。方法采用后路切开椎弓根螺钉系统内固定加植骨术治疗腰椎疾患92例,其中采用传统进钉点(Weinstein法)置钉45例,共186枚钉;采用人字嵴顶点进钉47例,共196枚钉。比较两组置钉的准确性、手术时间、出血量及并发损伤情况。结果所有病例术后均做X线片及CT检查,A组横突法不良置钉率为6.5%,神经血管损害发生率为8.9%,B组人字嵴顶点进钉法不良置钉率为2.0%,神经血管损害发生率为2.1%。两组差异有统计学意义(P<0.05)。B组在置钉准确性、手术时间、出血量等方面明显优于A组横突法。结论腰椎人字嵴顶点进钉技术应用于腰椎弓根钉内固定,具有操作简便、置钉准确、易于掌握、创伤小、手术时间缩短等优点,可有效防止硬膜及神经根的损伤。Objective To compare the effect of pedicles screw fixation through entry point of the ＂人＂ shape crest and traditional entry point （Weinstein method）. Methods Ninety- two patients of lumbar spine disorders were treated by pedicles screw fixation combined with bone grafting through posterior approach. The screws were placed through the traditional entry point among 45 patients （group A, transverse process method, 186 screws）, the others were through entry point of the ＂人＂ shape crest （group B, ＂人＂ shape crest method, 196 screws）. The condition of accuracy of screw placement, operation time, bleeding amount and injury were compared. Results All patients accepted the examination of X- ray and CT scan after operation. The rate of screw bad placement was 6.5 % in group A and 2.0% in group B, the incidence of injury of nerve and blood vessel was 8.9% in group A and 2.1% in group B. The accuracy of screw placement, operational time and bleeding amount in group B were significantly better than those in group A （P〈0.05）. Conclusion The pedides screw fixation through entry point of the ＂人＂ shape crest has the characteristics of simple operation, accurate placement of screw, easy to grasp, tiny operational trauma and short operational time, which can prevent effectively the injury of dura mater and nerve mot.

关 键 词：腰椎 椎弓根 螺钉进钉点 

分 类 号：R681.5[医药卫生—骨科学] R687.32[医药卫生—外科学]