摘要
目的:比较两种下颈椎经关节螺钉植入方法的优缺点,提出并验证更为合理的植入方法,为临床提供参考。方法:运用8具颈椎标本随机模拟植入下颈椎经关节螺钉,植入的方法:一侧采用Takayasu法(记为A组),另一侧采用Dalcanto法(记为B组)。A、B两组分别统计:植入时关节突关节劈裂情况;横突孔侵犯情况;植入后神经根损伤情况;未通过关节突关节的螺钉数。结果:共植入下颈椎经关节突螺钉64枚,A、B两组各32枚。A组未见下关节突劈裂;B组见下关节突关节下缘劈裂7例,外缘劈裂3例;两组中均未见上关节突劈裂。A组中发现8枚螺钉侵犯横突孔,B组未见横突孔侵犯。神经根前支损伤A组11例,B组2例;神经根后支损伤A组8例,B组9例。经观察证实A组2例未经过关节突关节,B组均经过下关节突关节。结论:Takayasu法在螺钉植入过长时易引起神经根和椎动脉损伤,而Dalcanto法在植入螺钉时易引起下关节突劈裂。
Objective： To compare two techniques of the transartieular screw placement in the lower cervical spine, and to suggest and confirm a new technique of the placement. Methods：The techniques of transartieular screw placements used by Takayasu （group A） and Daleanto （group B ） were applied in eight cervical specimens. The splits of facets, the encroachment of the cervical nerve roots and transverse foramens were observed and analyzed. The numbers of transarticular screws which not gone through the facets were counted in both group A and B ,respectively. Results：Sixty-four transarticular screws were implanted, thirty-two for group A, the same for group B. Although no splits of the facets were seen in group A, two transartieular screws did not go through the facets. There were ten splits of facets in group B ,in which seven involved the inferior border of the inferior facets and three for the lateral border. No superior facets were found to be broken both in group A and B. Eight screws encroached the transverse foramens in group A and none in group B. Eleven of anterior branch and eight of posterior branch of lower cervical nerve roots were involved in group A, two and nine respectively in group B. Conclusion：There are high risk of injury of anterior branch of cervical nerve root and vertebral artery if the screws are too long and the Takayasu＇s technique is used. However,the rate of facet split is high if the Dalcanto＇s technique is applied.
出处
《中国骨伤》
CAS
2009年第8期590-592,共3页
China Journal of Orthopaedics and Traumatology
关键词
颈椎
内固定器
外科手术
Cervical vertebrae
Internal fixators
Surgical procedures,operative
