椎板关节突螺钉两种不同置钉方法的临床对比研究
曾忠友, 陈国军, 汤永华, 严卫峰, 吴鹏, 张建乔
中国临床解剖学杂志 ›› 2011, Vol. 29 ›› Issue (5) : 581-584.
椎板关节突螺钉两种不同置钉方法的临床对比研究
The comparision of two methods for placing translamina facet screw
目的 比较椎板关节突螺钉两种不同置钉方法的优缺点。 方法 回顾性分析2006年8月～2008年6月，采用椎板关节突螺钉固定联合椎间融合器植骨治疗单节段下腰椎病变47例，其中开放置钉21例，瞄准器引导下经皮置钉26例。两组病例在性别、年龄、病史时间、疾病类型、病变部位、疾病严重程度方面无统计学差异。 结果 两组病例均顺利完成手术，均未输血，术中、术后未出现相关并发症。两组病例术中导针穿刺次数、切口长度、手术时间、术中出血量、术后切口引流液量和术后螺钉位置相比差异有统计学意义（P＜0.05）；两组病例均获随访，随访时间12～36个月，平均19个月，两组病例融合率无差异。随访过程中两组病例均未出现螺钉松动、移位、断裂等现象，亦未出现椎间融合器移位现象，最后随访时两组JOA评分改善率相比差异无统计学意义（P＞0.05）。 结论 与开放置钉相比，瞄准器引导下经皮置钉具有创作小、操作简单、准确性和安全性高等优点，同时缩短了手术时间，因此，瞄准器可作为腰椎椎板关节突螺钉置钉的较好选择。
Objective To compare advantage and disadvantage of two different methods for placing the translamina facet screw. Methods The study reviewed 47 patients of low lumbar vertebra diseases underwent the surgery. 21 cases were placed screw by opening procedure, the others were placed screw by the percutanous gunsight guiding. There was no difference among the gender, age, history time, diseased type, diseased region and severity in two groups. Results All cases underwent the surgery successfully, with no complication occurred intraoperatively and postoperatively. There was significant differences among the times of intraoperative guide pin puncture, length of incision, operative time, intraoperative bleeding, postoperative incisal draining and postoperative screws location in two sets. All cases were followed-up for 12 to 36 months, averagely 19 months. 44 cases got bony fusion, only 3 suffered from poor bony fusion. Improving rate of the JOA grades was insignificant different in two sets. Conclusions Compared to that of opening fixation, the screw placing through percutanous gunsight guiding is more prevalent, such as the small surgery trauma, simple operation, high intraoperational safety, and short manipulation time. Therefore, gunsight is a good choice for translamina facet screw fixation.
Lamina facet screw / Fixation / gunsight / Percutanous / Low lumbar vertebrae
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