脊柱椎弓根螺钉置钉技术研究进展  

Progress on spinal pedicle screw placement

作　　者：刘运潮 侯树勋[2] 张宇鹏[2] 

机构地区：[1]第四军医大学西京医院骨科,西安710032 [2]解放军总医院第一附属医院全军骨科研究所,北京100048

出　　处：《中国骨与关节杂志》2016年第8期596-601,共6页Chinese Journal of Bone and Joint

摘　　要：自从1959年Boucher在脊柱融合手术中应用椎弓根螺钉技术以来,由于其能够实现三柱固定、为脊柱提供即刻牢固固定、矫形力量强大、可大幅度提高融合率等优势,在脊柱外科手术中的应用日益广泛,已先后用于脊柱创伤、炎症、肿瘤、畸形和退变性疾病等的治疗,取得公认的良好效果,在脊柱外科手术中有着不可替代的作用。Pedicle screw technology has been increasingly common in spinal surgery due to its advantages of three-column fixation, immediate fixation to the spine, strong orthopedic force, and significant improvement in fusion rate. To improve the insertion accuracy, a variety of screw systems have been proposed. The traditional freehand insertion has a rather long learning curve, and the contribution of clinical experience to the improvement of the insertion accuracy is limited. However, guided by imaging technologies, insertion accuracy is improved significantly. X-ray assisted screw insertion is the most common technology due to its lower economic cost and easier operation of the assisted equipment, but its accuracy in more complex cases like scoliosis needs to be improved. The new computeraided screw technology can provide accurate navigation in the surgery, but it is not common now due to high costs. Combined with 3D printing technology, the digital navigation templates assisted technology can set tailored navigation template for each patient by accurate pedicle screw placement at an inexpensive price. However, this technique has not been widely used since it costs much time for preoperative designing. In this paper, the research development of freehand（ unassisted） fixation, fixation by computer assisted navigation, fixation assisted by X-ray, and digital navigation template technique are summarized. Evaluation standards on fixation accuracy of pedicle screws are discussed to show the whole picture of pedicle screw placement for spine fusion.

关 键 词：脊柱 内固定器 椎弓根钉 体层摄影术 X线 外科手术 计算机辅助 

分 类 号：R687.3[医药卫生—骨科学]