摘要
目的分析胸腰椎经椎弓根内固定置钉位置不佳穿破骨壁的原因。方法对行椎弓根螺钉内固定手术术中探察、X线监测发现置钉位置不佳者18例,按穿破骨壁部位不同分析原因。结果18例患者中外侧壁穿破7例,内侧壁穿破3例,下侧壁穿破3例,穿破椎体前壁1例,进入上方椎间隙4例。结论脊柱先天畸形、退变、骨折、腰椎滑脱或脊柱侧凸等病变导致椎弓根局部解剖变异或不易辨认,术者未注意个体化、穿刺精度不高以及对经椎弓根穿刺时脊柱生物力学变化理解不够是置钉位置不佳的主要原因。
Objective To analyze the cause of malposition of transpedicular screw internal fixation in thoracolumbar spine and perforation of bone. Methods Eighteen cases of malposition of transpedicular screw internal fixation in thoracolumbar spine were detected by X-ray and the causes were analyzed according to the location of perforation. Results Perforation in lateral wall occurred in 7 cases,3 in medial wall,3 in bottom wall, I in fanterior wall and 4 into intervertebral space. Conclusion The major cause of malposition of transpedicular screw internal fixation were mutation of and ambiguity of opography induced by spinal congenital malformation, cataplasia, fracture, lumbar olisthe or lateral curvature ; neglect of individuality and poor accuracy in iroplanting pedicle screw and inadequate understanding of biomechanics of spine about paracentesis.
出处
《新乡医学院学报》
CAS
2007年第2期163-164,共2页
Journal of Xinxiang Medical University
关键词
胸腰椎
椎弓根螺钉
置钉不佳
thoracolumbar spine
pedicle screw
malposition
