经皮椎弓根置钉定位装置在胸腰椎经皮椎弓根置钉中的临床应用

摘要

ABSTRACT:Objective To investigate the clinical efficacy of screw positioning device in percuta-neous thoracolumbar pedicle screw placement.Methods Thirty patients with vertebral compres-sion fractures were assigned to receive percutaneous thoracolumbar pedicle screw placement by means of either pedicle screw positioning(experimental group,15 patients,60 pedicle screws)or kirschner wire positioning(control group,15 patients,60 pedicle screws).The frequency of C arm X-ray fluoroscopy,duration of operation and proportion of pedicle perforation were compared be-tween the two groups.Results Compared with control group,the frequency of C arm X-ray fluo-roscopy was decreased and the duration of operation was shortened in experimental group(P <0.05).No significant difference was found in the proportion of pedicle perforation between the two groups(P >0.05).Conclusion In percutaneous thoracolumbar pedicle screw placement,the application of screw positioning device can reduce the frequency of C arm X-ray fluoroscopy and shorten the duration of operation,although it cannot decrease the incidence of surgical complica-tions.Therefore,pedicle screw positioning is a safe and effective method for percutaneous thoraco-lumbar pedicle screw placement.%目的：探讨经皮椎弓根置钉定位装置在经皮椎弓根置钉术中的临床应用效果。方法收集采用经皮椎弓根螺钉置入术的椎体压缩性骨折患者30例，根据不同定位方法进行分组，试验组15例，采用经皮椎弓根定位装置定位，对照组15例，应用克氏针进行定位，椎弓根螺钉置入的数量均为60枚。比较2组使用 C 臂机 X 线透视次数、手术时间及螺钉穿破椎弓根比例。结果试验组 C 臂机 X 线透视次数少于对照组，手术时间短于对照组（均P ＜0．05）。2组椎弓根穿破比例比较差异无统计学意义（P ＞0．05）。结论在经皮椎弓根螺钉置入术中，经皮椎弓根定位装置的应用虽不能降低手术并发症的发生率，但可以减少术中 C 臂机 X 线透视次数及缩短手术时间，是一种安全、有效的定位方法。