关键词: 椎弓根螺钉, 　腰椎退变性疾病, 　螺钉植入法

Abstract:

Objective　To investigate the application effect of screw placed under direct vision in lumbar degenerative disease treated with pedicle screw fixation.　Methods　120 patients with lumbar degenerative disease were treated with pedicle screw fixation by an open posterior approach. According to the placement method of pedicle screw, they were divided into group A with 80 cases using the traditional method adopting the crista lambdoidalis as anatomical marker for screw placement (group A, 80 cases), and group B with 40 cases using the media-inferior edge of the pedicle as the anatomical landmark for screw placement under direct vision after laminectomy or fenestration as anatomical mark. There was no statistically significant difference in general data between the two groups (P>0.05). The fluoroscopy time, placement time of pedicle screw, intraoperative blood loss, position of screw, fusion rate, functionary recovery (JOA score) and incidence of complications were recorded and compared between the two groups.　Results　The fluoroscopy time, placement time, intraoperative blood loss and the position of screw in group B were less or better than those in group A, and the differences were statistically significant (P<0.05); the functional recovery and complications in group B were better than those in group A, but the differences were not statistically significant (P>0.05); the fusion rate was 100% in both groups.　Conclusions　The method of pedicle screw placed under direct vision is simple and effective, which can be used as a supplement to traditional methods in some cases for degenerative diseases of lumbar spine.

Key words:  , Pedicle screw；　Degenerative lumbar disease；　Placement method of screw