应用“漏斗法”和“球探技术”椎弓根植钉治疗上胸椎骨折临床效果分析  

Effect of“funnel technique”and“ball tip technique”in thoracic pedicle screw placement on upper thoracic vertebral fracture

作　　者：严小虎[1] 杨红胜[1] 曹宗锐[1] 常山[1] 隋曌[1] 

机构地区：[1]成都医学院第一附属医院骨科,成都610500

出　　处：《中华实用诊断与治疗杂志》2016年第8期786-788,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：2013年度四川省卫生厅项目(130395)

摘　　要：目的 探讨“漏斗法”联合“球探技术”置入椎弓根螺钉治疗上胸椎骨折的临床疗效。方法 回顾性分析采用“漏斗法”结合“球探技术”椎弓根植钉法治疗7例上胸椎骨折患者的临床资料,观察术后并发症、椎弓根螺钉位置、置钉失败率、术后神经功能恢复和植骨愈合情况。结果 7例患者共置入上胸椎椎弓根钉59枚,CT断层扫描显示无椎弓根内壁及前壁穿透,首次置钉成功率为93.2%;术中和术后均未出现血管、神经损伤及脑脊液漏等并发症;术后随访8~24个月,患者切口均一期愈合,后凸角纠正（11.0±3.3）°;无内固定松动、断裂发生,ASIA分级较术前改善;术后3~5个月,7例均达骨性融合。结论 “漏斗法”联合“球探技术”椎弓根螺钉置入治疗上胸椎骨折的实用性和安全性良好。Objective To investigate the effect of ＂funnel technique＂ and ＂ball tip technique＂ in thoracic pedicle screw placement on upper thoracic vertebral fracture. Methods The clinical data of 7 patients with upper thoracic vertebral fracture receiving ＂funnel technique＂ and ＂ball tip technique＂ in thoracic pedieae screw placement were retrospectively analyzed to observe the incidence of postoperative complications, screw position, screw placement failure rate, recovery of neurological function and bone graft healing. Results A total of 59 thoracic pedicle screws were placed by using ＂funnel technique＂ and ＂ball tip technique＂ in 7 patients with no penetrating through into inner or anterior wall of pedicle of vertebral arch on CT image. The first-time screw placement successful rate was 93.2%. No complications occurred as vascular and neurological disorders as well as eerebrospinal leak during and after operation. The follow up survey for 8 to 24 months revealed all incisions were primarily healed. The average kyphosis angle was corrected by （11.0±3.3）%. The bone graft survived, with no screw loosening or breaking. ASIA was improved after operation. All patients obtained bony fusion in 3 to 5 months after operation. Conclusion The method of ＂funnel technique＂ and ＂ball tip technique＂ in thoracic pediele screws placement is practical and safe in the treatment of upper thoracic vertebral fracture.

关 键 词：上胸椎骨折 “漏斗技术” “球探技术” 椎弓根螺钉 

分 类 号：R687.3[医药卫生—骨科学]