王向阳,徐华梓,池永龙,夏冬冬,林焱,黄其杉,毛方敏,倪文飞,徐晖,王胜.改良枢椎椎板螺钉置钉方法的临床应用[J].脊柱外科杂志,2016,14(4):216-219. |
改良枢椎椎板螺钉置钉方法的临床应用 点此下载全文 (Fulltext) |
王向阳 徐华梓 池永龙 夏冬冬 林焱 黄其杉 毛方敏 倪文飞 徐晖 王胜 |
温州医学院附属第二医院骨科医院脊柱外科, 浙江 325027 |
基金项目: |
DOI:10.3969/j.issn.1672-2957.2016.04.007 |
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摘要: |
目的 设计一种改良的枢椎椎板螺钉置钉方法并应用于临床,使螺钉置入更简单、更准确。方法 改良枢椎椎板螺钉置钉方法的进钉点仍为棘突和椎板的交界处,但在椎板中份用磨钻磨除少许皮质开窗,用刮匙刮除松质骨,保留椎板内板,用手钻沿着枢椎椎板钻孔,在直视下通过开窗处,再继续向前钻入,探针探查钉道并攻丝后置入直径3.5~4.0 mm、长度24~30 mm螺钉。临床应用26例,其中男17例,女9例,平均年龄56.7岁。结果 共置入42枚枢椎椎板螺钉,螺钉平均长度为27.1 mm(24~30 mm),术中无需透视,术中和术后无明显技术相关的并发症发生。术后即刻或随访CT示椎板螺钉位置正确,均位于椎板间。全组病例平均随访13.4个月,未发生螺钉松动、脱出或断裂。结论 改良的枢椎椎板螺钉置入技术操作简单,无需透视,并保证了螺钉处于正确位置。 |
关键词:寰椎 枢椎 齿突尖 脱位 脊柱骨折 骨折固定术,内 |
Modification of Wright's technique for axial translaminar screw fixation Fulltext |
WANG Xiang-yang XU Hua-zi CHI Yong-long XIA Dong-dong LIN Yan HUANG Qi-shan MAO Fang-min NI Wen-fei XU Hui WANG Sheng |
Department of Spinal Surgery, Second Affiliated Hospital, Wenzhou Medical College, Wenzhou 325027, Zhejiang, China |
Fund Project: |
Abstract: |
Objective To describe and illustrate a modification of Wright's technique for axial translaminar screw fixation. Methods With our modified technique,a small unicortical "hole" was made at the middle of the contralateral lamina,and the screw could be directly visualized through the unicortical "hole" to prevent violating the spinal canal. Twenty-six patients (17 males and 9 females,average age 56.7 years) underwent insertion of unilateral or bilateral translaminar screws by using our modified technique. Results With this modified technique,42 axial translaminar screws were inserted successfully without fluoroscopy. The mean length of the axial laminar screws was 27.1(range 24-30) mm. There were no intraoperative surgeryrelated complications. The mean follow-up period was 13.4 months. During the follow-up,no pullout,loosening,or breakage of the screws was observed. Conclusion The modified technique provides axial translaminar screw fixation procedure which is simple to operate,without the need of fluoroscopy,and accurate placement of screws. |
Keywords:Atlas Axis Odontoid process Dislocations Spinal fractures Fracture fixation,internal |
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