特发性脊柱侧凸后路矫形术中个体化选择椎弓根螺钉进钉点的研究  

Study of individually selection of the entrance point of pedicle screws in the surgery of idiopathic scoliosis

作　　者：殷海东[1] 苏培强[2] 彭焰[2] 黄明光[1] 杜庆钧[1] 黄东生[2] 

机构地区：[1]广东省佛山市顺德第一人民医院骨科,广东佛山528300 [2]中山大学第二附属医院骨科

出　　处：《中国医师杂志》2009年第3期292-295,共4页Journal of Chinese Physician

基　　金：基金项目：国家自然科学基金（编号：30700456）

摘　　要：目的探讨脊柱侧凸后路矫形术中椎弓根螺钉的进钉点选择对置钉准确性的影响。方法总结2006年3月～2008年9月手术治疗的27例LenkeⅠ型特发性脊柱侧凸患者，根据术中椎弓根螺钉的进钉点选择方法不同，全部病例可分为标准置钉组（A组）14例和个体化置钉组（B组）13例。术前2组病例的年龄、冠状面Cobb角、T5-T12后凸Cobb角、柔韧性和顶椎旋转度差异无统计学意义（P值〉0．05）。标准置钉组术中均采用文献推荐的进钉点选择方法，而个体化置钉组则根据术前CT预先设计出的进钉点来指导术中的进钉点选择。结果术后2组病例的手术时间、术中出血量、固定节段、Cobb角矫正率和顶椎去旋转率差异均无统计学意义（P值〉0．05）。个体化置钉组的置钉准确率要明显高于标准置钉组（P〈0．01）。结论个体化选择特发性脊柱侧凸患者的椎弓根螺钉进钉点能提高术者的置钉准确率。Objective To study the accuracy in placement pedicle screws with different method in the selection of entrance point in surgery of scoliosis. Method 27 cases with Lenke Ⅰ type of Adolescent Idiopathic Scoliosis （AIS） from Mar 2006 to September 2008, were retrospectively analyzed. 14 cases were randomly divided into standard group （group A） and the entrance point was the same one as described in literatures. 13 cases were randomly divided into individually group （group B） and the entrance point was designed by surgeons on CT scans before surgery. There was no statistical difference in the mean age at time of surgery, Cobb angle on coronal and saggital （T5 - T12 ） plane, flexibility and rotational degree of apical vertebra preoperatively between two groups. Result There was no statistical difference in the time of surgery, blood losing, fixation segments, correction rate in Cobb angle and rotational degree of apical vertebra between two groups. The accuracy in placement pediele screws in individually group was higher than that in control group （ P 〈 0. 01 ）. Conclusion The accuracy in placement pedicle screws in the surgery of scoliosis can be improved by individual selection of entrance point.

关 键 词：脊柱侧凸/外科学 骨折固定术 骨螺丝 

分 类 号：R687.3[医药卫生—骨科学]