基于重力线使用卡尺进行颈椎椎弓根螺钉置入准确性的体外研究。
In vitro study of accuracy of subaxial cervical pedicle screw insertion using calipers based on the gravity line.
作者信息
Yao Xiang, Liu Shiqing
机构信息
Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, PR China.
出版信息
PLoS One. 2017 Jul 20;12(7):e0181324. doi: 10.1371/journal.pone.0181324. eCollection 2017.
OBJECT
There is a high probability of iatrogenic perforation of the vertebral pedicle wall during the application of subaxial cervical pedicle screw (CPS). The goal of this study was to evaluate the accuracy of CPS insertion at C3-C7 in vitro using novel calipers based on the gravity line.
METHODS
Nine cadaveric cervical spines underwent computed tomography scanning and preoperative design. A lateral fluoroscopic view was taken to measure the intra-operative sagittal angle by C-arm with hanging cross structured K-wires. By referring to the gravity line, caliper A was used to locate the entry point, while caliper B was employed to guide the screw insertion. Postoperative CT scans were performed to assess the accuracy of the screw placements, according to the Neo classification.
RESULTS
Overall, 78 (88.6%) of the 88 pedicle screw placements were classified as grade 0 (correct position), 4 (4.5%) were grade 1 (non-critical perforation), 4 (4.5%) were grade 2 (critical perforation), and 2 (2.3%) were grade 3 (critical perforation).
CONCLUSIONS
Using our novel calipers and referring to the gravity line was helpful for locating and guiding individual cervical pedicle screw insertions.
目的
在下颈椎椎弓根螺钉（CPS）置入过程中，医源性椎弓根壁穿孔的可能性很高。本研究的目的是使用基于重力线的新型卡尺在体外评估C3 - C7节段CPS置入的准确性。
方法
对9具尸体颈椎进行计算机断层扫描和术前设计。采用C形臂和悬挂交叉结构克氏针进行术中侧位透视以测量矢状角。参照重力线，使用卡尺A定位进针点，使用卡尺B引导螺钉置入。术后进行CT扫描，根据Neo分类评估螺钉置入的准确性。
结果
总体而言，88枚椎弓根螺钉置入中，78枚（88.6%）被分类为0级（正确位置），4枚（4.5%）为1级（非关键穿孔），4枚（4.5%）为2级（关键穿孔），2枚（2.3%）为3级（关键穿孔）。
结论
使用我们的新型卡尺并参照重力线有助于定位和引导单个颈椎椎弓根螺钉的置入。
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