| 漏斗技术在胸椎椎弓根螺钉置入中的临床应用 |
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Received:April 20, 2010
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| 作者 | Author | 单位 | Unit | E-Mail |
| 汤呈宣 |
TANG Cheng-xuan |
温州医学院附属第三医院骨科, 浙江 温州 325200 |
Department of Orthopaedics and Spine Surgery, the Third Affiliated Hospital of Wenzhou Medical College, Wenzhou 325200, Zhejiang, China |
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| 杨国敬 |
YANG Guo-jing |
温州医学院附属第三医院骨科, 浙江 温州 325200 |
Department of Orthopaedics and Spine Surgery, the Third Affiliated Hospital of Wenzhou Medical College, Wenzhou 325200, Zhejiang, China |
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| 戴鸣海 |
DAI Ming-hai |
温州医学院附属第三医院骨科, 浙江 温州 325200 |
Department of Orthopaedics and Spine Surgery, the Third Affiliated Hospital of Wenzhou Medical College, Wenzhou 325200, Zhejiang, China |
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| 谢秉局 |
XIE Bing-ju |
温州医学院附属第三医院骨科, 浙江 温州 325200 |
Department of Orthopaedics and Spine Surgery, the Third Affiliated Hospital of Wenzhou Medical College, Wenzhou 325200, Zhejiang, China |
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| 张力成 |
ZHANG Li-cheng |
温州医学院附属第三医院骨科, 浙江 温州 325200 |
Department of Orthopaedics and Spine Surgery, the Third Affiliated Hospital of Wenzhou Medical College, Wenzhou 325200, Zhejiang, China |
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| 刘良乐 |
LIU Liang-le |
温州医学院附属第三医院骨科, 浙江 温州 325200 |
Department of Orthopaedics and Spine Surgery, the Third Affiliated Hospital of Wenzhou Medical College, Wenzhou 325200, Zhejiang, China |
liuliangle@163.com |
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| 期刊信息：《中国骨伤》2010年23卷，第12期，第911-914页 |
| DOI：10.3969/j.issn.1003-0034.2010.12.009 |
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目的：探讨采用“漏斗技术”置入胸椎椎弓根螺钉的准确性和安全性。
方法：回顾性分析了2005年8月至2008年3月至少有1枚螺钉置于T1-T10之间的39例患者的临床资料。其中，男27例，女14例，年龄17～56岁，平均38.5岁；1例失访，1例在随访前因非相关性原因死亡。根据术后薄层CT扫描评估置钉的安全性和准确性以及各种并发症。
结果：39例均获随访，时间18～30个月，平均23.2个月，未见血管、神经和内脏损伤等并发症。共置入胸椎椎弓根螺钉208枚，置钉准确性T1-T4低于T5-T8(P=0.80),T5-T8低于T9-T10(P=0.07),T1-T4低于T9-T10(P=0.06).27枚螺钉(13.0%)发生错置，其中，14枚(6.7%)穿破椎弓根外侧皮质，7枚(3.4%)穿破内侧皮质，5枚(2.4%)穿破椎弓根上壁，1枚(0.5%)穿出椎体侧方，未见椎弓根下壁和前壁穿破，4枚螺钉(1.9%)为危险性穿破。
结论：漏斗技术是一种简单、安全、准确和经济的椎弓根螺钉置入方法，通过该技术使年轻医师迅速安全、准确置入胸椎弓根螺钉成为可能。 |
| [关键词]:胸椎 内固定器 外科手术 骨折 肿瘤 |
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| Clinical application of “funnel technique” in planting thoracic pedicle screws |
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Abstract:
Objective: To evaluate the safety and accuracy of “funnel technique” in planting thoracic pedicle screws.
Methods: From August 2005 to March 2008,a total of 39 patients with at least one thoracic pedicle screw in T1-T10 using “funnel technique” were retrospectively reviewed. Among the patients,27 patients were male and 14 patients were female,with a mean age of 38.5 years (ranged from 17 to 56 years). One patient was lost follow-up,and other 1 patient was dead before follow-up. The accuracy of screw placement and the complications related to thoracic pedicle screws were analyzed by postoperative CT-scans.
Results: All the patients were followed up ranging from 18 to 30 months,averaged 23.2 months. There were no vascular or viscera complications as well as iatrogenic neurologic injuries. The total number of screws was 208. There was no statistical difference between the percentage of fully contained screws at T1-T4 versus T5-T8 (P=0.80),T5-T8 versus T9-T10 (P=0.07),T1-T4 versus T9-T10(P=0.06) . Twenty-seven screws(13.0%) were misplaced,14 screws ( 6.7%) violated lateral cortex of pedicle,7 screws(3.4%) medially,5 screws(2.4%) superiorly,1 screw(0.5%) violated lateral cortex of vertebral body. No violations occurred superiorly or anteriorly. Only 4 screws(1.9%) was a critical perforation.
Conclusion: The “funnel technique” is a simple,safe,accurate and cost-effective technique for pedicle screw placement. It provides even an entry-level surgeon with a safe way to identify and place thoracic pedicle screws. |
| KEYWORDS:Thoracic vertebrae Internal fixators Surgical procedures, operative Fractures Neoplasms |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 汤呈宣,杨国敬,戴鸣海,谢秉局,张力成,刘良乐.漏斗技术在胸椎椎弓根螺钉置入中的临床应用[J].中国骨伤,2010,23(12):911~914 |
| 英文格式: | TANG Cheng-xuan,YANG Guo-jing,DAI Ming-hai,XIE Bing-ju,ZHANG Li-cheng,LIU Liang-le.Clinical application of “funnel technique” in planting thoracic pedicle screws[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(12):911~914 |
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