椎弓根角度测量器在下颈椎内固定术中的应用

Application of pedicleangle measuring instrument in the fixation of lower cervical vertebra

目的 探讨颈后路椎弓根钉内固定术中应用椎弓根角度测量器辅助置钉的准确性及安全性。方法 纳入2015年1月~2019年1月行后路手术的40例下颈椎骨折脱位患者,随机分为观察组和对照组各20例。观察组术中透视下应用椎弓根角度测量器辅助置钉,对照组透视下徒手置钉。术后均行CT检查并分析两组患者置钉优良率、并发症情况等指标。结果 观察组置入93枚螺钉,优良率96.8%;对照组置入105枚螺钉,优良率为87.6%,观察组显著高于对照组(P<0.05)。观察组术后发生螺钉松动1例,发生率为5%;对照组发生螺钉松动1例,螺钉穿破椎弓根2例,总发生率为15%。观察组并发症发生率显著低于对照组(P<0.05)。结论 椎弓根角度测量器显著提高了置钉准确性,减少了手术时间、术中出血量及术后引流量,降低了术后并发症的发生率。

Objective To investigate the accuracy and safety of pedicle screw fixation assisted by pedicle angle measuring instrument in posterior cervical pedicle screw fixation.Methods A total of 40 patients with lower cervical spine fracture and dislocation who underwent posterior surgery from January 2015 to January 2019 were included in this study.The patients were randomly divided into observation group and control group,with 20 cases in each group.The observation group was assisted with pedicle screw placement under intraoperative fluoroscopy,while the control group was treated with freehand pedicle screw placement under fluoroscopy.Postoperative CT examination was performed in both two groups,and indicators such as excellent and good rate of screw placement,complications were analyzed.Results Ninety-three screws were inserted in the observation group,with an excellent and good rate of 96.8%.A total of 105 screws were placed in the control group,with an excellent and good rate of 87.6%,which was significantly lower than that in the observation group(P<0.05).In the observation group,there were 0 case of postoperative incision infection,0 case of incision nonunion,and 1 case of screw loosening,with a total incidence rate of 5%.In the control group,there were 0 case of incision infection,0 case of incision nonunion,1 case of screw loosening,and 2 cases of screw puncture and vertebral pedicle,with a total incidence rate of 15%.The incidence rate of complications of the observation group was significantly lower than that of the control group(P<0.05).Conclusion Pedicle angle measuring instrument assisted screw placement can significantly improve accuracy,reduce operation time,intraoperative blood loss and postoperative drainage volume,and reduce the incidence of postoperative complications.