投影法植入椎弓根螺钉的可行性

目的探讨通过椎弓根的投影法植入椎弓根螺钉的可行性及临床应用价值。方法通过对椎弓根的解剖及椎弓根投影的影像解剖研究,探讨通过椎弓根投影植入椎弓根螺钉的可行性,临床上前瞻性地利用该法植入胸椎椎弓根螺钉50枚,腰椎椎弓根86枚,术后CT复查。胸椎植入的成功率与经典Margel法对比,腰椎植入的成功率与经典的AO法对比,利用SPSS13.0的Pearson Chi-Squaretest对结果进行统计分析,分析该法与AO及Margel法的成功率是否存在显著差异。结果椎弓根的投影就是椎弓根行径在X线片及CT片上的投影,临床利用椎弓根的投影法植入胸椎螺钉16例50枚,Margel法31例74枚,投影法植入腰椎螺钉23例86枚,AO法32例142枚,投影法胸椎的成功率明显高于Margel法,腰椎的成功率与AO法没有明显的显著性差异。结论椎弓根投影法植入螺钉的方法是可靠、可行的。

Feasibility of Pedicle Screw Implantation According to Image of Pedicle of Thoracolumbar Vertebrae

Objective To investigate the feasibility of pedicle screw implantation according to image of thoracolumbar pedicle. Methods By studying the growth and development of pedicle and the image of thoracolumbar pedicle in digital radiography (DR) and CT, and by measuring thoracolumbar pedicles,the results of 50 cases of thoracic pedicle screw implantation and 86 cases of lumbar pedicles screw implantation were prospectively observed according to the image of thoracic and lumbar pedicles. The operation results were divided into 3 groups including inside the pedicle group, medial wall penetration group and lateral wall penetration group.The results of image method were compared with Margel and AO method by Pearson Chi-Square test in SPSS 13.0.Results Image of thoracolumbar pedicle was the projection in DR and CT. It could be shown clearly in the DR and CT. In our clinic study, pedicle screw implantation according to image of thoracolumbar pedicle was successful and showed highly successful ratio to Margel method, but without significant difference with AO method.Conclusion The method of pedicle screw implantation according to image of thoracolumbar pedicle is scientific and feasible.