Xu R, Ebraheim N A, Ou Y, Yeasting R A
Department of Orthopaedic Surgery, Medical College of Ohio, Toledo, USA.
Spine (Phila Pa 1976). 1998 May 1;23(9):1065-8. doi: 10.1097/00007632-199805010-00021.
In this cadaveric study, the outcomes of two techniques for pedicle screw placement in the thoracic spine were compared.
To assess the Roy-Camille technique, and to determine whether pedicle screw placement, aided by partial laminectomy, could decrease the incidence of pedicle violations.
Pedicle screw fixation in the thoracic spine remains technically challenging. The Roy-Camille method may be one of the leading techniques of thoracic pedicle screw placement. However, there are few studies evaluating this technique and determining methods to decrease the incidence of thoracic pedicle penetration with screw insertion.
Ten cadaveric thoracic spines from T1 to T10 were used for pedicle screw placement. Two techniques of transpedicular screw placement were used, the Roy-Camille technique (screw placed on the right side; used in 95 screw placements) and the open-lamina technique screw placement with combined partial laminectomy (screw placed on the left side; used in 94 screw placements). After screw placement, all specimens were evaluated visually to determine violation of the pedicle.
The screw placement with the Roy-Camille technique had a higher percentage of pedicle violation (54.7%) than did that with the open-lamina technique (15.9%). No Grade III violation was seen in the screw placement with the open-lamina technique.
The Roy-Camille technique was associated with a high incidence of pedicle violation, whereas screw placement with a partial laminectomy significantly reduced the incidence of pedicle violation. Pedicle screw fixation in the thoracic spine remains a technical challenge and should not be used routinely. Screw placement with the open-lamina technique is recommended if pedicle screw fixation is strongly indicated in the thoracic spine.
在这项尸体研究中，比较了两种胸椎椎弓根螺钉置入技术的结果。
评估罗伊 - 卡米尔技术，并确定在部分椎板切除术辅助下的椎弓根螺钉置入是否能降低椎弓根侵犯的发生率。
胸椎椎弓根螺钉固定在技术上仍然具有挑战性。罗伊 - 卡米尔方法可能是胸椎椎弓根螺钉置入的主要技术之一。然而，评估该技术并确定降低螺钉置入时胸椎椎弓根穿透发生率的方法的研究很少。
使用10具从T1至T10的尸体胸椎进行椎弓根螺钉置入。采用两种经椎弓根螺钉置入技术，即罗伊 - 卡米尔技术（螺钉置于右侧；用于95次螺钉置入）和联合部分椎板切除术的开放椎板技术螺钉置入（螺钉置于左侧；用于94次螺钉置入）。螺钉置入后，对所有标本进行肉眼评估以确定椎弓根侵犯情况。
罗伊 - 卡米尔技术的螺钉置入椎弓根侵犯百分比（54.7%）高于开放椎板技术（15.9%）。开放椎板技术的螺钉置入未发现III级侵犯。
罗伊 - 卡米尔技术与较高的椎弓根侵犯发生率相关，而部分椎板切除术的螺钉置入显著降低了椎弓根侵犯的发生率。胸椎椎弓根螺钉固定仍然是一项技术挑战，不应常规使用。如果强烈指征在胸椎进行椎弓根螺钉固定，建议采用开放椎板技术进行螺钉置入。
