摘要
目的研究俯卧位64排CT扫描及改良椎弓根置钉参数测量方法对青少年特发性脊柱侧弯手术置钉的精确定位作用。方法 21例青少年特发性脊柱侧弯,术前采用俯卧位64排CT扫描,在常规测量内倾角、旋转角及进针深度的基础上,行进针点三维定位,并测量椎弓根松质骨宽度及矢状角,对手术置钉进行精确定位。术后低剂量CT扫描评估置钉准确率及冠位主弯Cobb’s角平均矫正角度。结果共植入螺钉226枚,置钉偏差5枚,置钉准确率97.8%,无椎弓根膨胀性改变和椎间盘损伤。术后冠位主弯cobb’s角平均矫正角度15.6°(2.0°～58.3°)。结论俯卧位64排CT扫描及改良椎弓根置钉参数测量方法对青少年特发性脊柱侧弯手术置钉的定位准确性高,具有临床推广价值。
Objective To evaluate 64-slice CT scaning in prone position and improved measurements of pedicle parameters to guiding accurately the pedicle screws placement in adolescent idiopathic scoliosis（AIS）.Methods Twenty-one patients with AIS who admitted in our hospital from January 2009 to June 2010 were enrolled in this study.They were 8 males and 13 female at a menaing age of 15.2（ranging from 6 to 18.8）.All patients underwent preoperatively 64-slice CT scaning in prone position.On the reconstructed CT images,3 dimentional localization of pedicle entry point,the width of pedicle spongy bone and the sagittal angle were measured in addition to the traditional pedicle parameters（pedicle inclination angle,pedicle depth and vertebral rotation angle）.The pedicle screws insertion was guided by the improved pedicle parameter measurements.Postoperatively,low dose CT scanning was performed to evaluate the accuracy of pedicle screw placement and the Cobb＇s angle.Results A total number of 226 screws were inserted into the pedicles,in which 5（2.2%） were displaced,and 221 were within the safe zone with an accuracy rate of 97.8%.No pedicle expansion or intervertebral disk injury was found.The Cobb＇s angles were corrected to 2° to 58.3°（mean 15.6°） from preoperative 42.2° to 112.3°（mean 62.1°）.Conclusion Prone 64-slice CT scanning and modified pedicle parameter measurements can improve the accuracy of pedicle screws placement in AIS,and should be applied widely in clinical practice.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2011年第11期1191-1194,共4页
Journal of Third Military Medical University
关键词
俯卧位
体层摄影术
X线计算机
螺钉
脊柱侧弯
prone position
tomography
X-ray computed
screws
adolescent idiopathic scoliosis
