盲置法颈椎弓根螺钉置钉技术的简化与应用  

A simple method for cervical pedicle screws insertion

作　　者：傅一山[1] 徐建广[1] 眭述平[1] 曾炳芳[1] 

机构地区：[1]上海交通大学附属第六人民医院骨科,200233

出　　处：《脊柱外科杂志》2008年第2期73-75,共3页Journal of Spinal Surgery

摘　　要：目的探索一种安全、简便、有效的颈椎弓根螺钉置钉方法,便于临床的推广。方法应用颈椎弓根螺钉内固定技术治疗患者11例,共置钉64枚,平均年龄为36岁,其中10例为颈椎外伤,1例为颈椎后纵韧带骨化(连续型)。结果平均随访16个月,最后随访时X线片显示骨融合良好,无内固定松动或断裂。术中出血量平均约500mL,每枚螺钉置钉所花时间平均约为3min,9例54枚螺钉术后行X线及CT扫描进行椎弓根螺钉位置评价,均置钉成功;2例10枚螺钉术后因经济因素仅行X线检查,螺钉位置良好,无并发症发生。结论在C3～7节段,"一点两垂直法"用于颈椎弓根螺钉的置钉既安全又简便,适用于临床推广,但在术前仍应进行个体化评估,排除手术的禁忌。Objective To explore a simple and safe method for cervical pedicle screws insertion. Methods Eleven eases were underwent cervical pediele screws fixation and 64 screws were inserted, averaged 36 years old. Among these, 10 cases were cervical spine injuries, 1 case was cervical ossification of the posterior longitudinal ligament （OPLL）. Results Followup averaged 16 months. At the final follow-up, the X-rays showed good bone fusion in all cases, and no fixation failure was found. Blood lost averaged 500 mL, the time of one screw insertion averaged 3 minutes, 54 screws in 9 eases were documented successfidly by the X-rays and CT scans, and 10 screws in 2 eases were evaluated to be successful by X-rays without CT scan. No complications occurred. Conclusions From C3 to C7, the method of one point and two vertical line＇ was safe and simple for the pedicle screws insertion, and could be spread. But before the surgery, the cervical pedicle should be evaluated individually.

关 键 词：颈椎 骨螺丝 内固定器 脊柱融合术 

分 类 号：R687.32[医药卫生—骨科学]