椎弓根螺钉在胸腰段定位的实验研究及临床意义

An experimental study of the localization of pedicle screw in thoracolumbar vertebrae and its clinical significance

椎弓根螺钉固定常因位置不当所造成的严重并发症阻碍普及，为研究其正确位置，在１２具新鲜尸体胸腰椎节段脊柱标本上（共１０８节脊椎）钻入２１６枚椎弓根螺钉，经正侧位Ｘ线摄片测量和计算判定及解剖方法验证螺丝钉在椎弓根内位置。结果表明Ｘ线片测量和计算能准确地判定螺丝钉的位置及穿出椎弓根的部位且与解剖验证相吻合。同时还提出怎样选择胸腰椎进钉点及进钉方向。本研究方法简单，准确率高。

It has been noted that the complications resulting from improper location of pedicle screw prevent the pedicle fixation technique from being widely used. In the present study, 108 thoracolumbar vertebrae in 12 cadavers were drilled with 216 pedicle screws and then X ray examination, calculation and anatomic detection were conducted to determine the sites of the pedicle screws. It was indicated that X ray examination and calculation could accurately determine the location of the pedicle screws and the undrilled vertebrae and this was consistent with the results of anatomic detection. The selection of the points and direction of screw drilling was also discussed. Our results suggest that the method we have created is accurate and simple and can resolve the key problem of screw drilling accuracy in clinical application of pedicle fixation technique.