"钥匙孔式"开窗椎弓根探查结合盲置法在颈椎椎弓根固定术中的应用

目的探讨“钥匙孔式”开窗椎弓根探查结合盲置法行颈椎椎弓根固定术的临床应用价值。方法介绍“钥匙孔式”开窗椎弓根探查结合盲置法的置钉方法,对40例患者采用此法行颈椎椎弓根内固定术,术后X线和CT观察骨性愈合和椎弓根螺钉位置,螺钉穿透皮质率以及神经功能恢复情况。结果31例获随访,平均随访35个月,28例患者固定良好,并已达骨性融合;3例局部骨性愈合,无内固定松动,螺钉穿透皮质率仅为6．74％。29例脊髓损伤患者神经功能均有所恢复,仅有1例神经症状加重。结论“钥匙孔式”开窗椎弓根探查结合盲置法是一种良好的颈椎椎弓根固定方法,安全性高,有临床应用价值。

Keyhole partial laminectomy and tapping technique combined blind transpedicular screw placement in cervical spine

Objective To investigate the clinical efficacy and safety of keyhole partial laminectomy and tapping technique combined blindly transpedicular screw placement in cervical spine. Methods Keyhole partial laminectomy and tapping technique combined blindly transpedicular screw placement, was introduced. It was performed in 40 patients. The fusion and screw position were observated in postoperative X-ray and CT, and the breach of pedicle were evaluated. Neurological improvement was followed up. Results Thirty-one cases were followed up, the mean follow-up period was 35 months. 28 cases srew fixation firmly and fusion completely, 3 cases fusion partly and no screw loosening, only 6.74% had a critical breach. Neurological function were improved in 29 cases of spinal cord injuries ,only critical complication in one case. Conclusions Keyhole partial laminectomy and tapping technique, combined blind placement is one of most usefull, feasible and safe procedures in transpedicular screw placement of the cervical spine.