第2骶椎骶髂螺钉固定骶骨骨盆的优势及意义  

Advantages and significance of S2 alar iliac screw fixation in sacropelvic fixation

作　　者：刘钢[1] 杨强[1] 郝永宏[1] 邓树才[1] Liu Gang;Yang Qiang;Hao Yonghong;Deng Shucai(Tianjin Hospital,Tianjin 300211,China)

机构地区：[1]天津市天津医院,天津市300211

出　　处：《中国组织工程研究》2021年第21期3395-3400,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金面上项目(81871782),项目负责人:杨强。

摘　　要：背景:在脊柱畸形、肿瘤等的外科治疗中,实现腰骶交界处牢固稳定的固定是手术中的重要操作,且具有相对较大的挑战,术后并发症(如假关节、内固定失败和松动)的发生率较高。骶骨中骨组织的机械强度低,腰椎和骨盆中的较大负荷导致内固定拔出的风险增高,进一步导致内固定松动。虽然存在一些较为有效的手术方案,但技术的复杂性经常导致不满意的临床结果。目的:概述关于骶骨骨盆固定技术以及第2骶椎(S2)骶髂螺钉临床应用的最新研究进展,为临床治疗提供参考。方法:利用计算机检索中国知网、万方数据库、PubMed中2005至2020年的相关文章,检索词为"骶髂螺钉,S2AI,髂骨螺钉,骶骨骨盆固定,S2 alar iliac screw,Iliac screw,sacropelvic fixation,alar iliac screw"。查阅相关文章,最终共纳入43篇文献进行分析。结果与结论:①在脊柱长节段固定的下端增加了骶骨骨盆固定,如髂骨和S_2骶髂螺钉,以解决上述相关并发症;②S2骶髂螺钉置入技术在稳定骶髂关节方面发挥重要作用,因其独特的置钉方式,可避免螺钉脱位,减轻术后骶髂关节疼痛,降低了再次手术的风险;③S2骶髂螺钉作为脊柱骨盆固定的新兴技术,有着多方面的优势及临床意义,但由于骶髂关节复杂多样的结构及患者个体差异,使S_2骶髂螺钉的临床应用仍存在着相关问题。BACKGROUND:In the surgical treatment of spinal deformities and tumors,the firm and stable fixation of the lumbosacral junction is a task that must be completed in the operation,and it is a relatively great challenge.The incidence rate of postope rative complicatfons(such as pseudarthrosis,failure of internal fixation and loosening)is high.The mechanical strength of the bone tissue in the sacrum is low,and the high load in the lumbar vertebrae and pelvis increases the risk ofintemal fixation pullout,which fu rther leads to the loosening of the instrument.Although there are some of the most effective surgical techniques,the complexity of surgical techniques often leads to unsatisfactory clinical results OBJECTIVE:To summarize the latest research progress on the sacropelvic fixation and clinical applications of the S2 alar iliac(S2AI)screws,and provide a reference for clinical treatment.METHODS:The computer was used to sea rch articles published from 2005 to 2020 in CN KI,Wanfang,and PubMed.The search terms were"S2 alar iliac screw,S2AI,iliac screw,sacropelvic fixation,ala r iliac screw"in English and Chinese.Relevant articles were consulted,and finally 43 articles were included for analysis.RESULTS AND CONCLUSION:(1)Sacral pelvic fixation,such as ilium and S2AI screw,was added to the lower end of long segmental fixation of the spine to solve the above-mentioned related complications.(2)S2AI screw placement technique plays an impo rtant role in stabilizing sacroiliac joint.Because of its unique screw placement method,it avoids screw dislocation,reduces postoperative sacroiliac joint pain and reduces the risk of reoperation.(3)As a new technology of spinal and pelvic fixation,S2AI screw has many advantages and clinical significance,but due to the complex and diverse structure of sacroiliac joint and individual differences of patients,there are still related problems in clinical application of S2AI screw.

关 键 词：第2骶椎骶髂螺钉 髂骨钉 置钉 徒手 导航 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]