胸腰椎钉棒角度距离测量仪的研制及在腰椎滑脱手术复位中的研究  

Development of thoracolumbar vertebral screw-rod angle distance measuring instrument and experimental study on its application in lumbar spondylolisthesis diaplasis surgery

作　　者：黄志海[1] 王正安[1] 徐跃根[1] 胡安全[1] 陆永强[1] 王立章[2] 郭连军[3] 

机构地区：[1]浙江省嘉兴市第一医院9A病区,314000 [2]浙江省嘉兴市第一医院放射科,314000 [3]嘉兴学院医学院解剖教研室

出　　处：《中华实验外科杂志》2015年第1期129-131,共3页Chinese Journal of Experimental Surgery

基　　金：嘉兴市2012年科技计划资助项目（2012AY1070-12）;嘉兴市重点学科（扶持学科）资助项目（04-F-20）

摘　　要：目的 研制一种胸腰椎后路短节段矫形手术中的测量工具,以期提高腰椎滑脱复位效果.方法 研制胸腰椎钉棒角度距离测量仪,将成人脊柱腰骶段带骨盆尸体标本6具制成第五腰椎滑脱模型,双侧置入第五腰椎、第一骶椎椎弓根螺钉,使用胸腰椎钉棒角度距离测量仪测量椎弓根螺钉之间的距离、矢状面夹角,根据数据确定固定棒长度及折弯曲度并用胸腰椎钉棒角度距离测量仪检验,在适当撑开椎间隙下安装固定棒完成腰椎滑脱复位手术模拟.比较脊柱标本、置钉后滑脱模型、复位后滑脱模型的滑脱百分率、滑脱间隙椎间节段前凸角、滑脱间隙椎间后缘高度.结果 模型复位后滑脱百分率（0％、1％、0％、1％、0％、2％）、滑脱间隙椎间节段前凸角（20.60°、20.50°、21.30°、21.00°、20.00°、20.40°）、滑脱间隙椎间后缘高度（6.03、6.81、6.71、6.95、6.31、6.60 mm）均恢复到脊柱标本初始状态,达到了解剖复位.结论 胸腰椎钉棒角度距离测量仪有助于腰椎滑脱的解剖复位,临床应用前景广泛.Objective To develop a kind of measuring tool for the thoraco-lumbar posterior short segment orthopedic surgery,to improve effectiveness of lumbar spondylolisthesis diaplasis.Methods The “thoracolumbar vertebral screw-rod angle distance measuring instrument” was developed.The models of the fifth lumbar vertebrae spondylolisthesis were made with 6 adult spinals.Bilateral pedicle screws were placed on the models.The longth and bending degree of fixing rods were calculated according to the distance and sagittal angle between the up and down pedide screws measured by “thoracolumbar vertebral screw-rod angle distance measuring instrument”,then the rods were placed on the models to complete the simulation diapasis of lumbar spondylolisthesis.The spinal specimens,spondylolisthesis models after placed pedicle screws and models after operation were divided into 3 groups,and their percentage of sliping segmental,the segmental loadosis of sliping segmental and the hind intervertebral edge height of sliping segmental were compared.Results All sliping models achieved a satisfacory recovery after operation,the percentage of slippage （0%,1%,0%,1%,0%,2%） were corrected,the segmental loadosis of sliping segmental （20.60°,20.50°,21.30°,21.00°,20.00°,20.40°） were closed to nomal,and the hind intervertebral edge height of sliping segmental （6.03,6.81,6.71,6.95,6.31,6.60 mm） returned to initial state.The analysis of status is significance.Conclusion The “thoracolumbar vertebral screw-rod angle distance measuring instrument” can be conducive to the anatomical reduction of the spondylolisthesis,and has a broad application prospect on the orthopedic surgery of thoracolumbar spinal posterior short segment.

关 键 词：胸腰椎 角度 距离 椎体滑脱 手术复位 

分 类 号：R687.3[医药卫生—骨科学]