中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (48): 9015-9018.doi: 10.3969/j.issn.1673-8225.2011.48.021

• 骨与关节图像与影像 bone and joint imaging • 上一篇    下一篇

三维CT重建参照下徒手寰枢椎椎弓根螺钉置入内固定治疗外伤性寰枢椎不稳

彭  科，胡优威，谭益云，张  健，曾凯斌   

  1. 湘潭市中心医院脊柱外科，湖南省湘潭市  411100
  • 收稿日期:2011-07-07 修回日期:2011-09-17 出版日期:2011-11-26 发布日期:2011-11-26
  • 作者简介:彭科★，男，1980年生，湖南省湘潭县人，汉族，2011年中南大学湘雅医学院毕业，硕士，主治医师，主要从事脊柱外科方面的研究。 davidgatesus@163.com

Atlantoaxial pedicle screw internal fixation for the treatment of atlantoaxial instability under three-dimensional CT reconstruction

Peng Ke, Hu You-wei, Tan Yi-yun, Zhang Jian, Zeng Kai-bin   

  1. Department of Spine Surgery, Xiangtan Central Hospital, Xiangtan  411100, Hunan Province, China
  • Received:2011-07-07 Revised:2011-09-17 Online:2011-11-26 Published:2011-11-26
  • About author:Peng Ke★, Master, Attending physician, Department of Spine Surgery, Xiangtan Central Hospital, Xiangtan 411100, Hunan Province, China davidgatesus@163.com

PDF

566

被引次数

6

摘要：

背景：寰枢椎椎弓根螺钉内固定在三维CT重建参照下比传统方法能提高置钉的准确率，减少置入并发症。
目的：探讨以寰枢椎三维CT重建为参照，进行寰枢椎椎弓根螺钉内固定治疗外伤性寰枢椎不稳的方法，明确其手术指导意义以及临床治疗效果。　
方法：对30例因外伤导致寰枢椎不稳需行寰枢椎椎弓根螺钉内固定治疗的患者内固定置入前行三维CT重建。
结果与结论：与螺钉置入前设计钉道内倾度、设计钉道测得进钉点与中线的距离比较，经C1、C2椎弓根螺钉实际钉道内倾角及进钉点与中线的距离差异均无显著性意义。30例患者观察到的C1后弓及C2椎弓表面解剖特征与置入前CT容积再现的影像一致。说明根据三维CT重建图像为参照进行寰枢椎椎弓根螺钉内固定，徒手置入，节省时间，并减少术中接收X线辐射，个性化置钉，精确、安全性高、疗效优良。

关键词: 寰枢椎, 三维CT重建, 椎弓根螺钉, 内倾角, 内固定, 寰枢椎不稳

Abstract:

BACKGROUND: Compared with traditional methods, atlantoaxial pedicle screw internal fixation by three-dimensional (3D) CT reconstruction can improve the accuracy rate and decrease the complication of the pedicle screw internal fixation.
OBJECTIVE: To investigate the treatment method of atlantoaxial instability with the atlantoaxial pedicle screw fixation, with the reference of 3D CT reconstruction of atlas and epistropheus, and to identify its operational directive significance and clinical treatment effects.
METHODS: A total of 30 patients with atlantoaxial instability caused by trauma were recruited, 3D CT reconstructions of atlas and epistropheus were performed before atlantoaxial pedicle screw internal fixation.
RESULTS AND CONCLUTION: No statistical significance was found between actual and designed inclination angle of entrance path and distance between midline and the entrance point for C1 and C2 pedicle screw. The intraoperative anatomical morphology of C1 posterior arch and C2 vertebral arch was consistent with pre-operative CT volume reconstruction images. Pedicle screw internal fixation based on pre-operative CT reconstruction is safe, accurate and effective with few complications and lower X-ray radiation.

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