椎弓根螺钉植入导向器的研制及体外应用研究

目的　分析自制椎弓根螺钉导向器提高椎弓根螺钉植入的准确性。　方法　根据椎弓根的解剖特点 ,研制椎弓根螺钉植入导向器。用多层螺旋 CT测量 2具胸椎标本 (T1 ～ T1 0 )椎弓根的三维定量解剖数据。依据其中轴的水平位角 (transverse section angle,TSA)和矢状位角 (sagittal section angle,SSA)值 ,调节导向器水平和矢状刻度盘角度。植入螺钉后拔出 ,用显影剂填充钉道。 CT测量显影钉道的 TSA和 SSA值。　结果　析因设计资料方差分析显示 ,椎弓根显影钉道的 TSA、SSA与其中轴的 TSA、SSA间差异无统计学意义 (P>0 .0 5 )。　结论　椎弓根螺钉导向器操作简便 ,其导向使钉道达到理想角度 ,能减少椎弓根穿破的发生。

FABRICATION AND APPLICATION IN VITRO OF PEDICLE GUIDE DEVICE FOR PEDICLE SCREWS INSERTION

Objective To evaluate the accuracy of pedicle guide device for the placement of the pedicle screws. Methods Pedicle guide device was designed and made for the anatomical trait of pedicle. The 3 D anatomical data of the thoracic pedicles were measured by multi slice spiral CT in two embalmed human cadaveric thoracic pedicles spine(T 1 T 10 ). Depending on transverse section angle(TSA) and sagittal section angle(SSA) of pedicle axis, the degree of horizontal dial and sagittal dial were adjusted in the guide device. The screws were inserted bilaterally in the thoracic pedicles by using the device. After pulling the screws out, the pathways were filled with contrast media. The TSA and SSA of developed pathways were measured. Results Analysis of the difference between pedicle axis and developed pathway was of no statistical significance( P >0.05). Conclusion The guide device could be easily operated and guarantee high accuracy of the pathways of screws and the incidence of pedicle penetration could be significantly reduced.