Vaccaro A R, Rizzolo S J, Balderston R A, Allardyce T J, Garfin S R, Dolinskas C, An H S
Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
J Bone Joint Surg Am. 1995 Aug;77(8):1200-6. doi: 10.2106/00004623-199508000-00009.
We used computerized tomographic scans and subsequent dissections to evaluate the position of ninety pedicle screws that had been inserted bilaterally into the fourth through twelfth thoracic vertebrae of five fresh-frozen cadavera. The screws had been inserted by five experienced spine surgeons without the use of radiographs or imaging studies. Of the ninety screws, thirty-seven were found to have penetrated the cortex of the pedicle. Twenty-one screws had penetrated the medial cortex and entered the spinal canal, and sixteen had penetrated the lateral cortex. The aorta and the esophagus were at greatest risk for injury after advancement of the screws beyond the anterior vertebral cortex. Computerized tomographic scans of the thoracic spine in nineteen living controls who did not have a spinal abnormality confirmed the proximity of the posterior mediastinal structures to the misplaced screws.
我们使用计算机断层扫描及后续解剖，以评估90枚椎弓根螺钉的位置，这些螺钉已双侧植入5具新鲜冷冻尸体的第4至第12胸椎。这些螺钉由5名经验丰富的脊柱外科医生在未使用X线片或影像学检查的情况下植入。在这90枚螺钉中，发现37枚穿透了椎弓根皮质。21枚螺钉穿透内侧皮质并进入椎管，16枚穿透外侧皮质。螺钉向前超出椎体前皮质后，主动脉和食管受伤风险最大。对19名无脊柱异常的活体对照者进行的胸椎计算机断层扫描证实了后纵隔结构与位置不当螺钉的接近程度。
