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颈椎椎弓根螺钉固定术的历史演变、生物力学优势、临床应用及安全置入技术综述

A Review of the Historical Evolution, Biomechanical Advantage, Clinical Applications, and Safe Insertion Techniques of Cervical Pedicle Screw Fixation.

作者信息

Tukkapuram Venkata Ramakrishna, Kuniyoshi Abumi, Ito Manabu

机构信息

Department of Neurosurgery, Sakra World Hospital, Devarabeesanahalli, Bangalore, India.

Department of orthopaedics, Sapporo Orthopaedic Hospital, Sapporo, Japan.

出版信息

Spine Surg Relat Res. 2018 Oct 10;3(2):126-135. doi: 10.22603/ssrr.2018-0055. eCollection 2019 Apr 27.

Abstract

Cervical spine instrumentation is evolving with an aim of stabilizing traumatic and non-traumatic cases of the cervical spine with a beneficial reduction, better biomechanical strength, and a strong construct with minimal intraoperative, as well as immediate and late postoperative complications. The evolution from interspinous wiring till cervical pedicle screws has changed the outlook in treating the cervical spine pathologies with maximum 3D stability, decreasing the duration of postoperative immobilization and hospital stay. Some complications associated with the use of cervical pedicle screw can be catastrophic. This review article discusses the morphometry of cervical pedicle; indications, biomechanical superiority, tricks, and pitfalls of cervical pedicle screw; complications and technical advancements in targeting safe surgery; and future directions of cervical pedicle screw instrumentation.

摘要

颈椎内固定技术正在不断发展,旨在稳定颈椎的创伤性和非创伤性病例,实现有益的复位、更好的生物力学强度以及构建坚固且术中、术后早期和晚期并发症最少的结构。从棘突间钢丝固定到颈椎椎弓根螺钉的演变,改变了治疗颈椎疾病的前景,实现了最大程度的三维稳定性,缩短了术后固定时间和住院时间。使用颈椎椎弓根螺钉可能会引发一些灾难性并发症。本文综述了颈椎椎弓根的形态测量;颈椎椎弓根螺钉的适应证、生物力学优势、技巧和陷阱;安全手术的并发症及技术进展;以及颈椎椎弓根螺钉内固定技术的未来发展方向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6a9/6690082/ac999480f7e7/2432-261X-3-0126-g001.jpg

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