“漏斗技术”在胸腰椎椎弓根钉内固定中的应用

Clinical application of pedicle screw implantation in thoracic and lumbar spine using funnel technique

目的探讨"漏斗技术"置入胸腰椎椎弓根螺钉的准确性并探讨其置钉方法。方法 69例胸椎或腰椎骨折、15例腰椎滑脱患者采用漏斗技术置入胸腰椎椎弓根螺钉,术中根据第12肋骨、骶骨或骨折的横突等标志确定椎体次序,记录置入操作中和术后并发症,其中34例术后行CT断层扫描检查判断螺钉的位置,记录穿透骨皮质螺钉的数目和距离。结果采用"漏斗技术"置入胸椎及腰椎椎弓螺钉338枚,1例术中即发现椎体次序定位错误。所有病例术后X线片观察椎弓根螺钉位置良好,CT观察136枚螺钉有5枚穿透椎体前骨皮质,无一枚穿透椎弓根内侧壁;术中和术后未出现神经、血管和脑脊液漏等并发症。结论椎弓根漏斗技术植入螺钉的方法是可靠、可行的。

Objective To evaluate the accuracy and method of pedicle screw implantation in the thoracic and lumbar spine by funnel technique.Methods A total of 84 patients were subjected to thoracic and lumbar pedicle screw fixation.The spinal segments were identified with the marks of 12th rib,sacrum and tranaverse process.Their perioperative complications were reviewed.The accuracy of screw placement was evaluated with X ray in all cases and CT in 34 cases of the group.Results A total of 338 thoracic and lumbar pedicle screws were placed by funnel technique.One case was complicated with wrong location of segment.Thirty-four patients were scanned with computed tomography to determine the screw＇s position,in which 5 screws penetrated the cortical wall.No neurovascular or cerebrospinal fluid leakage was found.Conclusion The method of pedicle screw implantation by funnel technique is scientific and feasible.