胸腰椎椎弓根螺钉位置不良临床病例初次探讨  

Thoracolumbar pedicle screw position adverse to explore the initial clinical cases

作　　者：赵辉[1] 巩陈[1] 

机构地区：[1]亳州市人民医院,安徽236804

出　　处：《安徽卫生职业技术学院学报》2014年第5期18-19,共2页Journal of Anhui Health Vocational & Technical College

摘　　要：目的:探讨胸腰椎椎弓根螺钉内固定置钉位置失误的原因、危害及预防措施。方法:回顾性分析200例患者行胸腰椎椎弓根螺钉内固定,共置入螺钉1150枚,观察患者术后的症状体征、正侧位X线、薄层CT平扫结果,观察螺钉在椎弓根内的位置、角度和穿破椎弓根骨皮质的情况。结果:36枚螺钉穿出了椎弓根皮质,失误率3.130%。术后出现神经根损伤表现5例,占总螺钉的0.43%,占位置不良螺钉的13.89%。结论:经椎弓根固定较易出现螺钉位置不良,可能导致神经根损伤,置钉需要个体化,术前要仔细研究患者影像资料,术中C臂透视确认,发现螺钉位置不良及时调整,可以有效减少胸腰椎椎弓根螺钉的置钉不良发生率。Objective：To investigate the thoracolumbar pedicle screw fixation pedicle screw position errors cause harm and preventive measures.Methods：A retrospective analysis of 200 patients in the hospital fixed line thoracolumbar pediele screws were implanted screws 1150, signs and symptoms observed in patients after surgery, lateral X-ray, thin CT scan results,Position of the screws in the pedicle angle and circumstances perforation of the cortical bone of the pediele and breakthrough from indexing according to the cortical bone.Results：36 pedicle screw piercing the cortex, error rate 3.130%.Postoperative performance of five cases of nerve root injury, 0.43% of the total screw, representing 13.89% of adverse screw position.Conclusion：The pedicle screw fixation prone to bad position, may lead to nerve root injury,pedicle screws need individualized patient image data to study carefully the preoperative, intraoperative C-arm fluoroscopy confirmed discovery of adverse timely adjustment screw position can be effective in reducin~ the incidence of adverse thoracolumbar Dedicle screw oedicle screws.

关 键 词：胸腰椎 椎弓根螺钉 内固定术 置钉不良 失误分析 

分 类 号：R687[医药卫生—骨科学]