摘要
[目的]探讨以椎板边缘对腰椎椎弓根螺钉进钉点个体化定位方法的有效性和可靠性。[方法]取4具脊柱骨骼标本,以L2为中心摄取X线正位片,测量椎弓根中心点与椎板上缘和外缘的垂直和水平距离,据此在椎弓根中心点涂钡剂,再摄片,测量钡点与椎弓根圈的关系;测量107例正常腰椎正位X线片上椎板边缘与椎弓根中心点的距离,对不同性别和不同投照中心的数据进行比较;对40例腰椎经椎弓根内固定病人应用了此进钉定位方法,复习了30例以横突、关节突为定位标志的经椎弓根内固定病人的住院资料。[结果]实验发现除L5椎板外缘显示欠清楚外,其余椎板边缘均显示清楚,标本上置钉选点的准确率达92.5%;在正常X线片上发现射线中心线对其附近3个节段内的椎板边缘与椎弓根的关系没有明显影响;临床应用发现一次性置钉准确率96%,平均手术时间96min,平均失血量212ml,与横突、关节突组比较有显著性差异。[结论]以椎板边缘对腰椎椎弓根螺钉进钉点个体化定位方法是可行和可靠的、创伤小、准确率高。
[ Objective ] To investigate the effectivity and reliability of individualized method to localize the entrance point of the lumbar pedicle screws by vertebral plate borderline. [ Methods] Four vertebra specimen were taken the X-ray film of anterior-posterior views as the center of L2. On the X-ray film, the distance between the centre-point of the pedicle to the lateral and superior margins of the vertebral plate were measured, after applied barium at the centre-point of the pedicle, the specimen were taken the X-ray film once more, the relation of the barium to the centre-point of the pedicle was measured; the distance between the centre-point of the pedicle to the lateral and superior margins of the vertebral plate were measured on the normal lumbar X-ray film in 107 cases, the data in different sex and different projection＇s center were compared; the method were applied to 40 patients of lumbar pedicle internal fixation, the information in hospital were reviewed to 30 patients of the lumbar pedicle screw localization by transverse process and transverse process. [ Results ] All （except L5 ） of lumbar plate borderline were displayed clear in the experiment, accurate rate of setpoint to be 92. 5%. The principal X-ray affected scarely to the relation of the pedicle with the plate borderline of nearby two segment, but affected obviously far from three segment on the normal lumbar X-ray film; the accurate rate of one time＇s setpoint in clinical application was 96%, average operation＇s time being 96 minute, average lose blood being 212 ml, transverse articular process＇s group showed significant difference. [ Conclusion] Individualized localization of the lumbar pedicle screw entrance points by vertebral plate borderline is one of feasible method, displayed less trauma and accurate rate highly in the clinical application.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2008年第3期207-210,共4页
Orthopedic Journal of China
关键词
腰椎
椎弓根钉
内固定
椎板
lumbar
lumbar pediele screw
internal fixation
vertebral plate
