椎弓根内壁显露法在寰枢椎椎弓根固定中的应用

Clinical application of pedicle screw fixation in atlas and axis by using the inner wall of pedicle exposure method

目的探讨椎弓根内壁显露在寰枢椎椎弓根固定的临床应用价值。方法通过显露寰椎椎弓根内壁和枢椎椎弓根内上壁,共置入椎弓根螺钉219枚,其中寰椎107枚,枢椎112枚。结果一次性置钉成功198枚,术后X线和CT检查螺钉均位于椎弓根内,上倾及内倾角度良好,无置钉有关的并发症。结论术中显露寰椎椎弓根内壁和枢椎椎弓根内上壁,可以提高寰枢椎椎弓根螺钉的置钉准确率,减少透视次数,减少出血量,节约手术时间,适合临床推广使用。

Objective To investigate the clinical value of pedicle screw in atlas and axis by using the inner wall of pedicle exposure method. Methods Patiants were treated by the exposure of the inner wall of atlas pedicle and the internal upper wall of axis pedicle,219 pedicle screws,of which 107 pieces of atlas and 112 pieces of axis were placed. Results One-time success was attained in 198 screws. The X-ray and CT examination screws were located in the pedicle after the operation,the result showed a good tilting angle and inclined angle. There were no complications related to screw insertion. Conclusions Intraoperative exposure of the inner wall of atlas pedicle and the internal upper wall of axis pedicle,which can improve the atlantoaxial pedicle screw placement accuracy rate,reduce the number of X-ray,reduce the amount of bleeding,save operation time,is suitable for clinical use.