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基于应力分析的颈胸交界处改良椎弓根螺钉固定:手术技术与结果。

Modified pedicle screw fixation under guidance of stress analysis for cervicothoracic junction: Surgical technique and outcomes.

出版信息

J Back Musculoskelet Rehabil. 2023;36(5):1087-1094. doi: 10.3233/BMR-220154.

Abstract

BACKGROUND

In cervicothoracic junction, the use of strong fixation device such as pedicle screw placement is often needed.

OBJECTIVE

The current study aimed to evaluate the accuracy and safety of pedicle screw placement using stress conduction analysis in the clinical application.

METHODS

We retrospectively collected patients who underwent pedicle screw internal fixation in cervicothoracic junction. Patients were divided into conventional nail placement (Group A) and modified pedicle screw implantation under guidance of stress analysis (Group B) according to the methods of pedicle screw placement. The accuracy of pedicle screw placement was assessed by computed tomography (CT) examination, and the success rate was calculated.

RESULTS

A total of 80 patients who underwent pedicle screw internal fixation in cervicothoracic junction were included. There were no obvious differences in baseline characteristics between two groups. The success rate of total screw placement, cervical spine screw placement and upper thoracic spine screw placement in Group B was higher than those in Group A (P< 0.001, P= 0.005, P= 0.008). Additionally, Heary Grade I in the Group B was higher than Group A (P= 0.001).

CONCLUSION

Stress analysis-guided technique can increase the accuracy of pedicle screw placement. Importantly, it meets the requirements of internal fixation of the cervicothoracic junction.

摘要

背景

在颈胸交界处,通常需要使用强固定装置,如椎弓根螺钉固定。

目的

本研究旨在评估使用应力量传导分析在临床应用中椎弓根螺钉置钉的准确性和安全性。

方法

我们回顾性收集了在颈胸交界处接受椎弓根螺钉内固定的患者。根据椎弓根螺钉放置方法,将患者分为常规钉放置(A 组)和改良椎弓根螺钉植入在应力量分析指导下(B 组)。通过计算机断层扫描(CT)检查评估椎弓根螺钉放置的准确性,并计算成功率。

结果

共纳入 80 例在颈胸交界处接受椎弓根螺钉内固定的患者。两组患者的基线特征无明显差异。B 组的总螺钉置入成功率、颈椎螺钉置入成功率和上胸椎螺钉置入成功率均高于 A 组(P<0.001,P=0.005,P=0.008)。此外,B 组的 Heary 分级 I 高于 A 组(P=0.001)。

结论

应力量分析引导技术可提高椎弓根螺钉放置的准确性。重要的是,它满足颈胸交界处内固定的要求。

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