DR及CT扫描在胸、腰椎骨折椎弓根钉内固定术中的应用

DR and CT Scan in the Thoracic Lumbar Fracture Pedicle Screw Internal Fixation

目的采用两种不同方法行胸、腰椎骨折椎弓根钉置钉，探讨DR及CT扫描在胸、腰椎骨折内固定术中的应用价值。方at按八院时间“日序选取我院2011年1月20l2年6月所做的80例胸、腰椎骨折患者，分为对照组40人和治疗纽40人，各置入160枚椎弓根螺钉，分别采用十字交叉法[1]及改良方法置入，根据术后CT扫描情况（是否有宇破椎弓根或椎体前方骨皮质，侵犯小关节，进入关节内及神经损伤情况），评估胸、腰椎骨折后的椎弓根螺钉置八效果。结朵各组胸、腰椎骨折患者置八l60枚螺钉中，十字交叉法纽置钉失误率达15．63％．改艮定位法置钉失误率达2．50％。结论对于基层医院医师，手术中结合DR及CT扫描所取得的病椎体上、下相邻椎体的置钉相关参数，有利于减少胸、腰椎骨折的椎弓根螺钉置入失误率。

Objective using two different methods in thoracic, lumbar flacture with pedicle nailing, discuss DR and CT scan in the thoracic, hnnhar vertebrae fracture fixation internal application value. Methods at the time order selection -2012did in June,8Ocases of admission to our hospital from 201 I January of thoracic lumbar spine fracture patients, divided into the control group40and treatment group 40people, the placement of160pedicle screws, respectively, by using cross method and improved method ofI＇l placement, according to the postoperative CT scan （whether there is through the pedicle or vertebral body and anterior corlical bone, the violation of the small joints, into the joint and nerve injury ）, assessment of the thoracic, lumbar fiactures after pedicle screw placenrent effect. Results All the thoracic, lumbar fracture patients after implantation of 160screws, cross method group placement error rate 15.63%, improved positioning pin failure rate 2.50%. Conclusion for the grass-roots hospital operation, with DR and CT scans the disease vertebral bodies adjacent vertebral screw insertion, under the relevant parameters, has the benefit of reduc- ing thoracic, lumbar fracture by pedicle screw insertion errorrate.