Department of Orthopaedic Surgery and Traumatology, Klinikum Esslingen, Hirschlandstrasse 97, 73730, Esslingen, Germany.
Laboratory for Applied and Clinical Anatomy, Department of Anatomy, Histology and Embriology, Semmelweis University, Budapest, Hungary.
Eur Spine J. 2022 Sep;31(9):2204-2211. doi: 10.1007/s00586-022-07126-w. Epub 2022 Feb 3.
Lumbar fusion using lateral single position surgery (LSPS) gained popularity during the last few years. While prone percutaneous pedicle screw placement is well described, placing percutaneous pedicle screws with the patient in the lateral position is considered the most complicated part of LSPS. In this article we describe the fluoroscopy navigated technique for lateral percutaneous screw placement using the tunnel view technique.
The radiologic background and principles of the tunnel view technique are described. In addition, the special positioning of the patient, the C-arm and the surgical technique is discussed in detail.
This technique is used as the standard for percutaneous screw placement in the prone or lateral positions in our department since 2017. Since the introduction of this technique we have had 0% reoperation rate for symptomatic malpositioned pedicle screws.
The tunnel view technique simplifies pedicle screw placement while allowing for permanent observation of pedicle walls and the superior joint surface during placement of the Jamshidi needle. It also allows for confirmation of intrapedicular position of the screw after its implantation. This technique is safe and feasible in our clinical experience.
近年来，腰椎融合术采用侧位单一入路手术（LSPS）越来越受欢迎。虽然经皮椎弓根螺钉置钉技术已得到广泛描述，但在侧卧位下进行经皮椎弓根螺钉置钉被认为是 LSPS 中最复杂的部分。本文介绍了使用隧道视图技术进行侧位经皮螺钉置钉的透视导航技术。
描述了隧道视图技术的放射学背景和原理。此外，还详细讨论了患者、C 臂和手术技术的特殊定位。
自 2017 年以来，该技术已成为我们科室在俯卧位或侧卧位下进行经皮螺钉置入的标准。自引入该技术以来，我们的症状性置钉位置不良的椎弓根螺钉的再手术率为 0%。
隧道视图技术简化了椎弓根螺钉的置入，同时允许在 Jamshidi 针置入过程中永久观察椎弓根壁和上关节面。它还允许在植入螺钉后确认螺钉的椎弓根内位置。在我们的临床经验中，该技术是安全可行的。
