徒手个体化下颈椎椎弓根螺钉置入技术的解剖学研究  

Individual Free-Hand Cervical Pedicle Screw Placement:An Anatomical Study

作　　者：张斌[1] 高松[1] 戴闽[1] 黄山虎[1] 宗世璋[1] 姚浩群[1] 曹凯[1] 刘志礼[1] 杨东[1] 段满生[1] 

机构地区：[1]南昌大学第一附属医院骨科,南昌330006

出　　处：《南昌大学学报（医学版）》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)

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.

关 键 词：徒手 个体化 下颈椎 椎弓根螺钉 解剖 

分 类 号：R322-3[医药卫生—人体解剖和组织胚胎学]