颈椎椎弓根螺钉个体化置钉技术的研究

An Individual Technique of Pedicle Screw Placement in Cervical Spine

目的颈椎椎弓根螺钉的个体化置钉的研究。方法进行128枚椎弓根螺钉的置入,采用椎弓根螺钉的个体化置入技术。手术前对患者颈椎的正侧位X线片进行研究,通过椎弓根纵轴在颈椎侧位像上的投射,确定椎弓根螺钉进钉点的横向进钉线(X线),通过对CT的研究,确定椎弓根纵轴在颈椎侧块上投射的点位,确定椎弓根螺钉进钉点的纵向定位线(Y线),在手术中通过两线的交点确定椎弓根螺钉的进钉点(O点),通过术前的X线确定椎弓根螺钉的头倾角和尾倾角,通过CT确定椎弓根螺钉的内倾角,最终确定椎弓根螺钉的进钉方向,结合手术中一定的操作技术,完成椎弓根螺钉的个体化置钉。结果本组正确置入118枚,螺钉穿透椎弓根但基本在椎弓根内的6枚,4枚穿出经调整后准确置入。结论颈椎椎弓根置钉应个体化。

Objective To report an individual method of pedicle screw in cervical spine. Methods The 128 screws were placed through the individual cervical pedicle screw method. The project location of pedicle axis in the lateral mass through A- P and lateral X - ray view was studied. X line which identified the transverse position of the pedicle entry point in the lateral mass was localized. The CT was studied. The Y line which identified the sagittal position was localized. The O point was the pedicle entry point which was the intersection of the X - line and Y - line. The sagittal angle according to the X - ray and the transverse angle was identified according to the CT scan. Based on this analysis, individual pedicle screw placement can be performed. Results A total of 128 screws were inserted and the position of 118 screws was correct. Six screws violated the pediele wall. Four screws were inserted correctly after adjusted. Conclusion Cerrical pedicle screw should be placed individually.