全皮质椎弓根螺钉剖析.ppt

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Page ? * 宁夏医科大学总医院心脑血管病医院骨科 宁夏医科大学总医院心脑血管病医院骨科 Page ? * 宁夏医科大学总医院心脑血管病医院骨科 Page ? * Page ? * 宁夏医科大学总医院心脑血管病医院骨科 Page ? * 宁夏医科大学总医院心脑血管病医院骨科 宁夏医科大学总医院心脑血管病医院骨科 Short-Term Results of Transforaminal Lumbar Interbody Fusion Using Pedicle Screw with Cortical Bone Trajectory Compared with Conventional Trajectory Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan 使用皮质骨螺钉植入与传统螺钉植入在TLIF手术中的短期结果 Introduction 前言 The clinical results of transforaminal lumbar interbody fusion (TLIF) have been favorable for degenerative spondylolisthesis, kyphoscoliosis, and instability of the lumbar spine. However, there has been concern regarding pedicle screw placement during TLIF。 TLIF手术的临床效果已经被很好的运用于腰椎退变性滑脱、脊柱侧后凸畸形及腰椎不稳。然而，TLIF手术过程中已经有关于椎弓根螺钉的定位。 Exposure lateral to the facet joint to insert a pedicle screw requires a relatively long incision and muscle dissection, which may be related to postoperative low back pain from injury to the posteromedial branch of the nerve root crossing the facet joint and damage to the exposed and retracted back musculature. To minimize the incision and muscle dissection and thus reduce these problems, TLIF with minimally invasive pedicle screw insertion (M-TLIF) and TLIF with percutaneous pedicle screw insertion (P-TLIF) have been developed. 暴露侧方到关节突关节去植入椎弓根螺钉需要相当长的切口和肌肉切开。这种手术因损伤穿过关节突的神经根后支及暴露过程中损伤背肌肉组织而引起后背痛。通过缩小切口及减少肌肉组织的剥离去减少这些问题，TLIF用于微创椎弓根螺钉植入和经皮椎弓根螺钉植入已经被很好的运用。 However, several clinical concerns, such as low back pain, learning curve, radiation exposure, and incorrect pedicle screw placement, have also been associated with M-TLIF and P-TLIF。 然而，在M-TLIF及P-TLIF手术中，几个临床上关注点诸如下腰痛，长的学习曲线，射线的暴露，以及椎弓根螺钉位置植入不正确也已经被证实发生。 A new trajectory for pedicle screw insertion of pedicle screw placement, the cortical bone trajectory (CBT), was reported by Santoni et al. in 2009 and may address these problems. The new trajectory was from medial t