脊柱骨折椎弓根螺钉置入准确率的影像学评估

发布时间：2018-01-25 03:10

本文关键词： 组织工程脊柱骨折骨科植入物人工假体脊柱骨折椎弓根螺钉 X射线影像学评估方法变化规律脊柱架标本 CT扫描　出处：《中国组织工程研究》2017年23期 　论文类型：期刊论文

【摘要】：背景:在脊柱骨折椎弓根螺钉置入中采用X射线及CT均能提高置钉准确率,且X射线成本较低,可重复好,能减少射线损伤,但是该结论尚未得到证实。目的:探讨X射线在脊柱骨折椎弓根螺钉置入中的应用效果及影像学评估方法。方法:选择2014年11月至2016年12月医院收治脊柱骨折患者20例(骨折部位T1-8),根据患者情况进行手术治疗,分别在椎弓根中部、椎体后缘及椎体前缘皮质下沿着椎弓根轴线进针,利用C臂X射线记录其位置及对应关系变化规律,患者在X射线引导下置入100枚椎弓根螺钉,置入螺钉后利用CT完成椎弓根螺钉位置、深度的评估,分析X射线在脊柱骨折椎弓根螺钉置入中的应用效果。结果与结论:C臂X射线下置入的实际钉道T1,T2,T3,T4,T5,T6,T7,T8钉道长度与虚拟钉道长度比较差异无显著性意义(P0.05),X射线置钉时同样能提高置钉的准确性。共置入100枚螺钉,94枚螺钉优,螺钉完全置入椎体内,方向、深度等符合要求;6枚螺钉良,螺钉基本在椎弓根内,螺钉的深度、方向基本符合要求,部分螺钉轻微穿破,但骨皮质较少;0枚差;100枚脊柱骨折椎弓根螺钉中标本并未出现穿破,穿破率为0%。结果证实,利用C臂X射线透析分步引导脊柱骨折椎弓根螺钉置入效果理想。
[Abstract]:Background: in spinal fractures by X ray and CT pedicle screw placement can improve the accuracy rate of screw placement, and X - low cost, good repeatability, can reduce radiation damage, but the conclusion has not been confirmed. Objective: To investigate the application effect of X ray in spinal fracture pedicle screw placement and the imaging evaluation methods: 20 cases of patients with fracture of spine were selected from November 2014 to December 2016 the hospital (fracture T1-8), surgical treatment according to the patient's condition, respectively in the central vertebral pedicle, and vertebral cortex along the pedicle axis into the needle, using C arm X ray records the position and the corresponding relationship between changes in patients X ray guided placement of 100 pedicle screws, screws after using CT pedicle screw placement, depth evaluation, X ray analysis in spinal fracture pedicle screw insertion into the application. Results. Results and conclusion: the actual placement of the C arm X ray T2, T3 screw T1, T4, T5, T6, T7, T8 screw length and virtual screw length had no significant difference (P0.05), X ray nailing can also improve the accuracy of pedicle screws were implanted. 100 screws, 94 screws, screw fully into the vertebral body, direction, depth to meet the requirements; 6 screws, screws in the pedicle screws of the basic, depth, direction of basic requirements, some screws slightly worn out, but the bone cortex is less; 0; 100 pedicle screws in spinal fracture samples did not appear worn out, perforation rate was 0%. results confirmed that using C arm X ray dialysis step by step guides spinal fracture ideal placement of pedicle screws.

【作者单位】：衡水市人民医院;河北医科大学第一附属医院;
【基金】：2015年河北省医学科学重点研究项目(20150032)~~
【分类号】：R687.3;R816.8
【正文快照】： 文章快速阅读:文题释义:胸腰椎螺钉置入导航技术的特点:胸腰椎螺钉置入导航技术结合电脑计算机的医学图像处理技术,能实现制定的可视三维化、空间立体化,可以通过定量化诊断、手术前或中模拟和预测、立体化定向导航技术以及远程化医疗等相互结合。脊柱骨折原因:多见男性青壮年

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