| 颈椎椎弓根螺钉内固定术中并发症及其对策 |
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投稿时间：2004-08-17
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| 作者 | Author | 单位 | Address | E-Mail |
| 校佰平 |
XIAO Bai-ping |
宁波市第六医院骨科,浙江宁波315040 |
Department of Orthopaedics, the 6th Hospital of Ningbo, Ningbo 315040,Zhejiang,China |
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| 徐荣明 |
XU Rong-ming |
宁波市第六医院骨科,浙江宁波315040 |
Department of Orthopaedics, the 6th Hospital of Ningbo, Ningbo 315040,Zhejiang,China |
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| 马维虎 |
MA Wei-hu |
宁波市第六医院骨科,浙江宁波315040 |
Department of Orthopaedics, the 6th Hospital of Ningbo, Ningbo 315040,Zhejiang,China |
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| 阮永平 |
RUA N Yong-ping |
宁波市第六医院骨科,浙江宁波315040 |
Department of Orthopaedics, the 6th Hospital of Ningbo, Ningbo 315040,Zhejiang,China |
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| 期刊信息：《中国骨伤》2005年，第18卷，第9期，第530-532页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目: |
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中文摘要:
目的:探讨颈椎椎弓根螺钉固定技术常见并发症及其处理方法。
方法:应用Axis内固定系统（美国枢法模公司）对69例颈椎病患者进行经后路椎弓根内固定术,术中清晰显露颈椎侧块和突间关节,用直径3.2mm高速球形磨钻去除侧块外上象限处骨皮质,然后用直径2.0mm的手锥沿椎弓根事先确定的方向轻轻钻入,使其自然置入,深约2.0~2.5cm。确定无误后,则安置Axis钛板和置入长度合适的椎弓根螺钉,完毕后用C形臂X线机作双斜位透视。
结果:从C3到C7,术中植入椎弓根螺钉314枚,其中21枚钉初次置入后感觉松动,经校正后二次置入成功,17枚钉道钻孔后出血较多,但及时处理后出血停止并无不良结果,其余螺钉置钉一次成功,未出现并发症。术后检查有28枚螺钉穿出椎弓根,6枚螺钉穿破椎弓根上侧皮质,3枚螺钉穿破椎弓根下侧皮质,12枚螺钉穿破椎弓根外侧皮质,7枚螺钉穿破椎弓根内侧皮质。随访未发现与螺钉置入穿破椎弓根皮质相关的神经血管损伤问题。
结论:手术前充分了解每个患者颈椎椎弓根影像学解剖结构,术中仔细按原则操作,正确处理则会明显减少术中及术后并发症的发生。 |
| 【关键词】颈椎 骨折固定术,内 并发症 骨科手术方法 |
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| Complications of cervical pedicle screw fixation and its managements |
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ABSTRACT
Objective: To study complications of cervical pedic le screw fixation and to find its manag ement.
Methods: Sixty-nine patients with cervical spine dixorders o r furactures treated with 314 pedicle sc rews were reviewed.Operation procedure w as hereinafter.Hand cones w ith 2.0 mm diameter were drilled along p re-decided route and its depth was 2.0 to 2.5 cm.Axis Tit an plates and cervical pedicle screws of s uitable length were put into and its sit e was determined by X-ray examination.
Results: From C3 to C7,314 cervical pedicle scr ew s were planted.Because of loose plant,21 screws were put in for the second time. Bleeding of 80 to 150 ml in 5 minutes fr om the pedicle hole was found in 17 case s.Postoperative examination showed that 28 screws penetrated pedicle of vertebra ,within them,6 penetrated upper cortex o f cervical p edicle,3 through lower cortex,12 externa l cortex and 7 interior cortex.Solid fusi on was achieved in 49 patients and no fusi on was found because the time of folow-u p was shorther(<6 months).C onclusion:Preoperative car eful evaluation of the morphology of the cervical pedicles and meticulous techniq ues of screw placement are essential in avoiding complications in a step-wise. |
| KEY WORDS Cervical vertebrae Fracture fixation,in ternal Complications Orthopaedics operative methods |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 校佰平,徐荣明,马维虎,阮永平.颈椎椎弓根螺钉内固定术中并发症及其对策[J].中国骨伤,2005,18(9):530~532 |
| 英文格式: | XIAO Bai-ping,XU Rong-ming,MA Wei-hu,RUA N Yong-ping.Complications of cervical pedicle screw fixation and its managements[J].zhongguo gu shang / China J Orthop Trauma ,2005,18(9):530~532 |
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