x线分步监测胸腰椎椎弓根螺钉植入的实验研究

《x线分步监测胸腰椎椎弓根螺钉植入的实验研究》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、X线分步监测胸腰椎椎弓根螺钉植入的实验研究【摘要】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

2、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】胸腰椎椎弓根螺钉透视X线Abstract［Objective］Toinvestigatethefeasibilit

3、yofthe11placementofpediclescrewsinthethoracolumbarvertebraeunderX-rayfluoroscopystepbystep.［Method］Eighthumancadavericthoracolumbarspines(T9～L5)wereselectedandclassifiedintogroupAandgroupBrandomly,eachhaving4specimens.PediclescrewsingroupAwereplacedunderX-rayfluoroscopystepbystep.CTscan

4、nedthespecimensofgroupAandmeasuredthehalfpediclelength,fullpediclelengthandthepediclescrewpassagelength.The“e”angleand“f”angleofpedicleweremeasuredonCTimages.Whentheguidewirewasprickedtothehalfofpediclelength,thewiretipwaslocatedatthemiddlelineofthepedicleprojectioninthestandardposterio

5、r-anteriorimage.Whenthewirewasprickedtothefullpediclelengthinlumbarvertebrae,itstipwaslocatedat3/4lineofthepedicleprojectioninthestandardposterior-anteriorimage.Whenthewirewasprickedtothefullpediclelengthinthoracicvertebrae,itstipwaslocatedatbetween1/2lineand3/4lineofthepedicleprojectio

6、n.Whenthewirewasprickedintovertebrae,thedepthofthewireandthe“e”anglewerenotedinstandardlateralimage.Pediclescrewswereplacedbythetrackoftheguidewire.PediclescrewsingroupBwereplacedbytraditionaltechnique.TheaccuracyandfeasibilityofthemethodunderX-rayfluoroscopystepbystepwereevaluatedby11o

7、bservationofthepositionofthepediclescrewsingroupAandgroupB.［Result］Fourof72(5.56%)pediclescrewswerefoundtohaveperforatedthepediclewallingroupA,and19of72(26.38%)pediclescrewsperforatedthepediclewallingroupB.TheresultofgroupAwassuperiortothatofgroupB(P＜0.001).［Conclusion］Themetho