| 姜伟琪,郭明明,孟令志,龙作尧,张怡光,龙雨,王琪,项良碧.L4/L5节段椎弓根螺钉进针点选择的新方法[J].脊柱外科杂志,2022,20(6):361-365. |
L4/L5节段椎弓根螺钉进针点选择的新方法  点此下载全文 (Fulltext) |
| 姜伟琪1 2 郭明明2 孟令志2 龙作尧2 张怡光2 龙雨2 王琪2* 项良碧2* |
1. 中国医科大学研究生院, 沈阳 110000;
2. 中国人民解放军北部战区总医院骨科, 沈阳 110000 |
| 基金项目：辽宁省科学技术计划项目（2019-ZD-1034） |
| DOI：10.3969/j.issn.1672-2957.2022.06.001 |
| 摘要点击次数: 819 |
| 全文下载次数: 309 |
| 摘要： |
| 目的 设计一种新的L4/L5节段椎弓根螺钉进针点的定位方法，并评估其准确性及安全性。方法 2019年1月-2020年8月，中国人民解放军北部战区总医院采用椎间融合并椎弓根螺钉内固定术治疗L4/L5节段椎间盘突出症患者98例，其中53例（观察组）采用新的进针点定位法（选择横突上缘下方4 mm与上关节突外缘交点处作为进针点），45例（对照组）采用人字嵴法进行进针点定位。记录并比较2组手术时间、术中出血量、首次置钉准确率、置钉前切口显露时间、螺钉与椎弓根皮质关系及并发症发生情况。采用疼痛视觉模拟量表（VAS）评分评估疼痛程度。结果 观察组共置入螺钉212枚，对照组置入180枚。2组手术时间、术中出血量、首次置钉准确率、螺钉与椎弓根皮质关系、术后VAS评分差异均无统计学意义（P>0.05）；观察组置钉前切口显露时间短于对照组，差异有统计学意义（P<0.05）。结论 L4/L5节段置入椎弓根螺钉，以椎体横突上缘下方4 mm与上关节突外缘交点处作为进针点，可获得与人字嵴定位法相同的置钉准确率和安全性，并可减少置钉前切口显露时间。 |
| 关键词：腰椎 椎间盘退行性变 脊柱融合术 内固定器 |
| A new method for locating pedicle screw insertion point at L4/L5 segment Fulltext |
| Jiang Weiqi1 2 Guo Mingming2 Meng Lingzhi2 Long Zuoyao2 Zhang Yiguang2 Long Yu2 Wang Qi2* Xiang Liangbi2* |
1. Department of Graduate School, China Medical University, Shenyang 110000, Liaoning, China;
2. Department of Orthopaedics, General Hospital of Northern Theater of Chinese PLA, Shenyang 110000, Liaoning, China |
| Fund Project: |
| Abstract: |
| Objective To design a new method for locating the pedicle screw insertion point at L4/L5 segment，and evaluate its accuracy and safety. Methods From January 2019 to August 2020，98 patients with L4/L5 intervertebral disc herniation were treated with interbody fusion and pedicle screw internal fixation in the General Hospital of Northern Theater of Chinese PLA，53 of whom（observation group） received a new method for locating the pedicle screw insertion point（the intersection of 4 mm below the superior edge of the transverse process and the outer edge of the superior articular process was selected as the pedicle screw insertion point），and 45 patients（control group） received the herringbone ridge positioning method for locating the pedicle screw insertion point. The operation time，intraoperative blood loss，accuracy of first screw placement，exposure time of incision before screw placement，relationship between screw and pedicle cortex and complications were recorded and compared between the 2 groups. Visual analogue scale（VAS） score was used to evaluate the intensity of pain. Results A total of 212 screws were implanted in the observation group and 180 in the control group. There was no significant difference between the 2 groups in operation time，intraoperative blood loss，accuracy of first screw placement，relationship between screw and pedicle cortex and postoperative VAS score（P>0.05）. The exposure time of incision before screw placement in the observation group was shorter than that in the control group，and the difference was statistically significant（P<0.05）. Conclusion Inserting pedicle screws at L4/L5 segment，and taking the intersection of 4 mm below the superior edge of the transverse process and the outer edge of the superior articular process as the pedicle screw insertion point，can obtain the same accuracy and safety of screw placement as the herringbone ridge positioning method，and also reduce the exposure time of the incision before screw placement. |
| Keywords:Lumbar vertebrae Intervertebral disc degeneration Spinal fusion Internal fixators |
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