X线分步监测胸腰椎椎弓根螺钉植入的实验研究Placement of pedicle screws undex X-ray fluoroscopy step by step in cadaveric thoracolumbar spine
王根林;杨惠林;蔡鑫;史金辉;唐天驷;
摘要(Abstract)：
[目的]探讨X线分步监测胸腰椎椎弓根螺钉准确置入的可行性。[方法]选8具T9~L5脊柱标本,随机分A、B两组,每组4具。A组按X线分步监测方法置入椎弓根螺钉。CT扫描测量椎弓根一半长、全长及螺钉通道长度和椎弓根e角及f角。当导针进至深度为椎弓根一半时,标准正位片导针远端到达椎弓根投影中线为符合标准;当导针进至深度为椎弓根全长时,腰椎到达椎弓根投影3/4处为符合标准,而胸椎到达椎弓根投影的1/2与3/4的中线处为符合标准;导针进入椎体,调整X线机臂,侧位片观察导针深度及f角。按照导针轨道植入椎弓根螺钉。B组为对照组,按传统X线监测方法置入椎弓根螺钉。通过观察两组螺钉的位置,评估A组方法的准确性。[结果]A组植入螺钉72枚:68枚位于椎弓根内,左右螺钉基本对称;4枚穿破椎弓根,穿破率为5.56%。B组亦为72枚:53枚位于椎弓根内;19枚穿破椎弓根,穿破率为26.38%。A组优于B组(P<0.001)。[结论]X线分步监测胸腰椎椎弓根螺钉的置入,可克服传统X线平片的局限性及减少置钉过程中的人为因素干扰,在一定程度上可使两侧椎弓根螺钉对称植入,提高了螺钉置入的准确性。
关键词(KeyWords)： 胸腰椎;椎弓根螺钉;透视;X线
基金项目(Foundation):
作者(Author): 王根林;杨惠林;蔡鑫;史金辉;唐天驷;
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参考文献(References)：
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