带预警装置椎弓根螺锥的临床应用

Application of pedicel screw driver with prior-warning set

目的探讨带预警装置椎弓根螺锥在胸腰椎手术应用中的优越性。方法回顾性研究自2010年9月．2011年10月收治的需进行椎弓根钉系统内固定的胸腰椎疾病30例，其中腰椎间盘突出16例，胸腰椎骨折10例，椎体滑脱4例。在减压解除神经压迫或复位椎体的同时利用带预警装置椎弓根螺锥行椎弓根钉固定。结果共置入160枚螺钉，术中及术后X线片评估椎弓根钉置钉准确度为100％，术后三维影像评估螺钉位置准确率为94．4％，螺钉平均置人时间（4．5±0．7）min/枚，未出现螺钉置人相关的近期并发症。结论在胸腰椎手术中应用带预警装置椎弓根螺锥行椎弓根钉置人，可有效提高置钉的精确性、安全性，缩短手术时间、减少术中出血量及放射线的暴露强度。

Objective To discuss the advantages of applying pedicle screw driver with prior-warning set in thoracolumbar spine surgery. Methods A retrospective study was conducted from September 2010 to October 2011.Thirty patients with thoracolumbar spine disease treated by pedicle screw fixation were included, which comprised of 16 lumber disc herniation, 10 thoracolumbar burst fractures and 4 lumbar spondylolisthesis. The pedicle screw driver with prior-warning set was applied simultaneously after the reduction of vertebral or decompression of neurological structure. Results One hundred and sixty pedicle screws were inserted.The accuracy of insertion position was 100% in the X-Ray evaluation in and after the surgery.The accuracy rate was 94% by postoperative 3D CT scan. The average insertion time was （4.5~0.7） rain per screw. None of the short-term screw insertion related complication was observed.Conclusion The application of pedicle screw with prior--warning set could effectively enhance the insertion accuracy and safety, shorten the surgical time and reduce the blood loss and X-ray exposure severity in thoracolumbar surgery.