腰椎椎弓根螺钉预出钉部位的放射解剖学分析

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1、中文摘要判断进钉深度较侧位片更准确，直观左、右30。斜位片能准确直观地观察钉尖与锥体前外侧骨皮质的位置关系。6月要椎前方毗邻结构:L,-L，左前方70。-90”为仁动脉，右前侧方为卜腔静脉50。-80'oL,椎体左、不!两侧方45。-70“有骼部血管。L,-L,"S螺钉进钉角度为5-10“时进钉过深有损伤F腔静脉的危险，进钊一角度为10-20。时有损伤主动脉的危险，进钊角度为0-50是较安全的。L;进钉角度为5-10“时有损伤N部血管的危险，进钉角度为10-20。相对安全。关键词:腰椎;椎弓根:内固定，钉尖位置:放射摄影术;并发症英文摘要RadiologicalAnatomicalS

2、tudyfortheExpectedPedicleScrewExitPositioninLumbarFixationABSTRACTPediclescrewsystemshavebeensuccessfullyusedintreatingspinaltumour,inflammationandtraumaforreconstructionofspinalstabilityandrealignmentofthespine.Thekeytosuccessofthistechniqueishowtoinsertthescrewintothevertebralbo即thoughthepedi

3、cleandsetitintheproperposition.Accuratemeansshouldbeusedforintraoperativedeterminationofproperscrewinsertionorscrewmalposition.AtpresentradiographyandC-armfluoroscopyarethetwomethodscommonlyusedtodetermineintraoperitiveanatomicalorientationanddepthofpediclescrew.Severalstudieshaveshownthestanda

4、rdintraoperativex-rayguidanceisnotreliableinassessingpediclescrewplacement.ComputerizedtomographyscanscandemonstratethepositionandthedepthofscrewpenetrationbutCTcannotbeusedinsurgicaloperation.Computer-assistedsystemshavebeenintroducedtoassessthescrewposition.Butthespecialinstrumentsanddifficul

5、tiestooperatelimititusage.Itisnecessarytofindasimpleaccuratemethodtodeterminethescrewatcorrectpositioningormalpositioninginordertoreducethe英文摘要complicationsandlowerthepotentialrisk.Objective:Simplyaccuratemethodsfordeterminingthepediclescrewpositioningwereprovidedthoughtheradiologicalanatomical

6、studyofthepediclescrewtips.Thatcanbeutilizedinoperationtoreducethecomplications.MaterialsandMethods:31drylumbarspecimens(310pedicles)wereobtainedforthestudy.1Anatomicalstudy:determinatethetoppoint“八”shapecrestofthelumbarpedicle.Thedistancefromthe“八”shapecresttothevertebraanteriorcortexandthescr

7、ewentranceanglefromthecenterofthepedicletotheaxisofthetransverseweremeasured.2Radiologicalanatomicalstu即:The310pedicles(155vertebrae)thatweretwinedwiththewires(1.0mmindiameter)aroundthenarrowpediclepartandstraightwirewereinsertedf