Chen Shaofeng, Li Bo, Liu Shu, Zhao Jian, Zhou Xiaoyi, Zhai Xiao, Gu Xiaochuan, Hou Canglong, Shi Zhicai, Bai Yushu, Li Ming, Mao Ningfang
Department of Orthopaedic Surgery, Changhai Hospital, The Navy Military Medical University, Second Military Medical University, 168 Changhai Road, Shanghai, 200433, China.
Department of Neurology, The General Hospital of Western Theater Command, Chengdu, China.
Eur Spine J. 2022 Dec;31(12):3536-3543. doi: 10.1007/s00586-022-07373-x. Epub 2022 Sep 29.
The short rod technique (SRT) is a novel method for lumbar pedicle screw placement to reduce surgical trauma and avoid damage to the facet joint and articular surface. The core concept is to change the entry point and angle of the screw on the vertebrae at both ends in the sagittal plane to shorten the length of the longitudinal rods. The purpose of this study is to determine the sagittal screw angle (SSA) and its safe Maximum (MAX) value on each lumbar vertebra for the SRT and to observe the shortening effect on the longitudinal rods.
A total of 152 healthy adults were investigated by measuring the lumbar spine lateral view images. The SSA and MAX-SSA were measured with SRT as reference to the conventional placement technique method. The distance between the entry points of the proximal and distal vertebrae was measured to compare the changes in the length of the longitudinal rods using the two screw placement techniques.
+ SSA increased from L1 to L4, and -SSA increased from L2 to L5, in which the -SSA of L2, L3, and L4 were significantly greater than those of + SSA (P < 0.05). + MAX-SSA at L1-L4 was 23.26 ± 3.54°, 23.68 ± 3.37°, 24.12 ± 3.29°, and 24.26 ± 3.42°, respectively. -MAX-SSA at L2-L5 was 36.25 ± 3.26°, 38.26 ± 3.73°, 38.62 ± 3.63° and 37.33 ± 3.31°, respectively. Theoretical reductions by calculation for the 2-segment lumbar pedicles were: L1-2: 9 mm, L2-3: 9.29 mm, L3-4: 6.23 mm, and L4-5: 7.08 mm; And the 3-segment lumbar pedicles were: L1-3: 16.97 mm, L2-4: 16.73 mm, L3-5, and 18.24 mm, respectively.
The application of the SRT to lumbar pedicles is a safe screw placement method that can significantly shorten the length of the used longitudinal rods.
短棒技术（SRT）是一种用于腰椎椎弓根螺钉置入的新方法，可减少手术创伤并避免损伤小关节和关节面。其核心概念是在矢状面改变两端椎体上螺钉的进针点和角度，以缩短纵向连接杆的长度。本研究的目的是确定短棒技术中各腰椎椎体的矢状面螺钉角度（SSA）及其安全最大值（MAX），并观察对纵向连接杆的缩短效果。
通过测量腰椎侧位影像对152名健康成年人进行研究。以传统置入技术方法为参照，采用短棒技术测量SSA和MAX-SSA。测量近端和远端椎体进针点之间的距离，以比较两种螺钉置入技术下纵向连接杆长度的变化。
+SSA从L1至L4增加，-SSA从L2至L5增加，其中L2、L3和L4的-SSA显著大于+SSA（P＜0.05）。L1-L4的+MAX-SSA分别为23.26±3.54°、23.68±3.37°、24.12±3.29°和24.26±3.42°。L2-L5的-MAX-SSA分别为36.25±3.26°、38.26±3.73°、38.62±3.63°和37.33±3.31°。计算得出的2节段腰椎椎弓根理论缩短值为：L1-2：9mm，L2-3：9.29mm，L3-4：6.23mm，L4-5：7.08mm；3节段腰椎椎弓根的理论缩短值分别为：L1-3：16.97mm，L2-4：16.73mm，L3-5：18.24mm。
短棒技术应用于腰椎椎弓根是一种安全的螺钉置入方法，可显著缩短所用纵向连接杆的长度。
