陈乃旺;庄青山;徐兆万;冀旭斌;厉锋;伦登兴;刘大勇;

• 1:山东省潍坊市人民医院脊柱外科

摘要(Abstract)：

[目的]介绍一种既提高疗效又安全可靠的颈椎椎弓根置钉新技术。[方法]回顾性研究本科2010～2018年收治的89例患者,置钉778枚,男42例,女47例;多节段颈椎骨折脱位19例、僵硬型或柔韧型颈椎后凸畸形伴狭窄症12例、颈椎管内肿瘤需关节突切除19例、强直性脊柱炎并颈椎骨折脱位16例、寰枢椎骨折脱位23例。五大技术整合应用于颈椎椎弓根内固定手术,包括术前规划、3D打印模拟手术、术中三维定向器辅助置钉、术中CT护航及术后CT评估。按照Lee等的方法判断椎弓根螺钉位置准确性。[结果] 89例患者778枚螺钉全部置钉成(2级+3级)。[结论]术前规划、3D打印模拟手术、术中三维定向器辅助置钉、术中CT护航及术后综合评估五大混合技术可明显减少颈椎椎弓根螺钉的并发症。

关键词(KeyWords)： 颈椎;椎弓根螺钉;并发症;预防

Abstract:

Keywords:

基金项目(Foundation): 山东省重点研发计划项目(编号:2018GSF118069)

作者(Author): 陈乃旺;庄青山;徐兆万;冀旭斌;厉锋;伦登兴;刘大勇;

Email:

DOI:

参考文献(References)：

• [1]Yukawa Y,Kato F,Yoshihara H,et al.Cervical pedicle screw fixation in 100 cases of unstable cervical injuries:pedicle axis views obtained using fluoroscopy[J].Neurosurg Spine,2006,5(6):488-493.
• [2]Kast E,Mohr K,Richter HP,et al.Complications of transpedicular screw fixation in the cervical spine[J].Eur Spine J,2006,15(3):327-334.
• [3]Yoshihara H,Passias PG,Errico TJ.Screw-related complications in the subaxial cervical spine with the use of lateral mass versus cervical pedicle screws:a systematic review[J].J Neurosurg Spine,2013,19(5):614-623.
• [4]Wang Y,Xie J,Yang Z,et a1.Computed tomography assessment of lateral pedicle wall perforation by free-hand subaxial cervical pedicle screw placement[J].Arch Orthop Trauma Surg,2013,133(7):901-909.
• [5]Sugimoto Y,Ho Y,Tomioka M,et a1.Vertebral rotation during pedicle screw insertion in patients with cervical injury[J].Acta Neurochir,2010,152(8):1343-1346.
• [6]Hu Y,Yuan ZS,Kepler CK,et a1.Deviation analysis of atlantoaxial pedicle screws assisted by a drill template[J].Orthopedics,2014,37(5):420-427.
• [7]Lu S,Xu YQ,Chen GP,et al.Efficacy and accuracy of a novel rapid prototyping drill template for cervical pedicle screw placement[J].Compute Aided Surg,2011,16(5):240-248.
• [8]Yoshii T,Hirai T,Sakai K,et al.Cervical pedicle screw placement using intraoperative computed tomography imaging with a mobile scanner gantry[J].Eur Spine J,2016,25(6):1690-1697.
• [9]Mendelsohn D,Strelzow J,Dea N,et al.Patient and surgeon radiation exposure during spinal instrumentation using intraoperative computed tomography based navigation[J].Spinal J,2016,16(3):343-354.
• [10]Nakashima H,Yukawa Y,Imagama S,et a1.Complications of cervical pedicle screw fixation for nontraumatie lesions:a multicenter study of 84 patients[J].J Neurosurg Spine,2012,16(31):238-247.