胸椎横突基底作为椎弓根螺钉置入点的 临床应用分析
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作者Author单位AddressE-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 xbp0412@126.com 
李明 LI 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  
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  
胡勇 HU Yong 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  
期刊信息:《中国骨伤》2009年,第22卷,第6期,第454-455页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:
中文摘要:

目的:探讨胸椎横突基底作为椎弓根螺钉置入点解剖及临床应用价值。

方法:132例患者采用胸椎横突基底作为椎弓根螺钉置入点的方法置入椎弓根螺钉,记录术中解剖观察及定位操作方法,观察术后患者并发症的发生情况。患者年龄12~77岁,平均(32±9)岁;其中男84例,女48例。胸椎骨折85例,胸椎退变性疾病27例,脊柱结核12例,脊柱肿瘤8例。

结果:所有椎弓根螺钉均徒手置入,共计螺钉788枚。以下胸段(T10-T12)置入螺钉最多为366枚,最少为T1 4枚。术中未发现大出血及脑脊液流出,未发现漏气。有13个椎弓根术中探查不良而予以及时改正,重新置钉。术后有2例诉有肋间麻木,经过2个月治疗后均消失,未再发现其他并发症。

结论:胸椎横突基底作为椎弓根螺钉置入点是一个较为可靠的临床应用技术,从解剖形态学的特点上解决了胸椎椎弓根螺钉进钉点确定难的问题。结合术前的X线片、CT、MRI等影像学检查结果,仔细操作,可以准确、安全、可靠地置入胸椎椎弓根螺钉。
【关键词】胸椎  骨折固定术  骨科手术方法  解剖
 
Clinical application of thoracic transverse process using as the position for thoracic pedicle screw implantation
ABSTRACT  

Objective: To investigate the anatomy and clinical application of thoracic transverse process using as the position for thoracic pedicle screw implantation.

Methods: A total of 132 patients were subjected to thoracic pedicle screws fixation and the pedicle screws implantation position was the basis of transverse process. The data of anatomy,operation method for position and their periopereative complications were reviewed. There were 84 male and 48 female with their age ranging from 12 to 77 years,with an average of 32±9 years,of which 85 patients sufferents from thoracic vertebral fracture,27 were thoracic degencrative disease,12 were thoracic tuberculosis and 8 were thoracic tumor.

Results: A total of 788 thoracic pedicle screws were placed by free hand technique,and the most of screws were implanted in low thoracic segments(T10-T12) while the least in T1. Massive hemorrhoea,leakage of cerebrospinal fluid and air leakage didn't occurre during operation. Thirteen thoracic pedicle screws were re-implanted during operation due to malposition. There are no perioperative complications expect for intercostal numbness founded in 2 patients and the symptom disappeared after 2 months therapy.

Conclusion: It is a reliable technique to use the basis of transverse process as the position for pedicle screw implantation,which solve the difficulty of ascertainment the entry point of thoracic pedicle screws. Thoracic pedicle screws can be managed accurately,safely and reliably based on careful manipulation and imageology data.
KEY WORDS  Thoracic vertebrae  Fracture fixation  Orthopaedics operative methods  Dissection
 
引用本文,请按以下格式著录参考文献:
中文格式:校佰平,李明,徐荣明,胡勇.胸椎横突基底作为椎弓根螺钉置入点的 临床应用分析[J].中国骨伤,2009,22(6):454~455
英文格式:XIAO Bai-ping,LI Ming,XU Rong-ming,HU Yong.Clinical application of thoracic transverse process using as the position for thoracic pedicle screw implantation[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(6):454~455
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