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首页> 外文期刊>Spine >Clinical evaluation and computed tomography scan analysis of screw tracts after percutaneous insertion of pedicle screws in the lumbar spine.
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Clinical evaluation and computed tomography scan analysis of screw tracts after percutaneous insertion of pedicle screws in the lumbar spine.

机译：在腰椎经皮插入椎弓根螺钉后，对螺钉束进行临床评估和计算机断层扫描扫描分析。

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STUDY DESIGN: An examination of the accuracy of percutaneous pedicle screw placement in the lumbar spine. Using computed tomography scan analysis after implant removal, the screw tracts could be analyzed regarding the degree and direction of screw dislocation. OBJECTIVES: To investigate the misplacement rate and related clinical complications of percutaneous pedicle screw insertion in the lumbar spine. SUMMARY OF BACKGROUND DATA: The feasibility of the external fixation test has been investigated in several studies. Although pedicle screw misplacement has been reported as one of the main complications, there are no reliable data on the misplacement rate for this difficult surgical procedure. METHODS: In this study, 51 consecutive patients with suspected segmental instability were investigated after external transpedicular screw insertion for the external fixation test. Computed tomography scans of all instrumented pedicles from L2 to S1 were performed after screw removal. The screw tracts were analyzed, and the direction and degree of the pedicle violations were noted. In addition, the screw and pedicle angles were measured. RESULTS: Of 408 percutaneously inserted pedicle screws, only 27 screws (6.6%) were misplaced. There were 19 medial pedicle violations, 6 lateral cortical defects, and only 1 cranial and 1 caudal displacement. With respect to the spinal level, S1 showed the highest misplacement rate, with 11 screw dislocations (12%). After surgery, found two nerve root injuries were found. Only one of the injuries (L4) was related to the malposition of a screw. CONCLUSIONS: This study has shown that percutaneous insertion of pedicle screws in the lumbar spine is a safe and reliable technique. Despite the low misplacement rate of only 6.6%, it should be kept in mind that the surgical procedure is technically demanding and should be performed only by experienced spine surgeons.
机译：研究设计：检查腰椎经皮椎弓根螺钉放置的准确性。使用植入物去除后的计算机断层扫描扫描分析，可以分析螺丝钉脱位的程度和方向。目的：探讨经皮椎弓根螺钉插入腰椎的错位发生率及相关的临床并发症。背景数据摘要：在一些研究中已经研究了外固定测试的可行性。尽管已经报道了椎弓根螺钉错位是主要并发症之一，但是对于这种困难的外科手术，没有关于错位率的可靠数据。方法：在本研究中，对连续51例怀疑节段不稳的患者进行了研究，他们均在行经椎弓根螺钉插入后进行了外固定试验。取下螺钉后，对从L2到S1的所有器械蒂进行计算机断层扫描。分析了螺钉束，并记录了椎弓根侵犯的方向和程度。另外，测量了螺钉角度和椎弓根角度。结果：在408枚经皮插入的椎弓根螺钉中，只有27颗螺钉（6.6％）被放错了位置。有19例侵犯椎弓根内侧，6个外侧皮质缺损，仅1例颅骨和1例尾椎移位。就脊柱水平而言，S1错位率最高，有11个螺钉脱位（12％）。手术后，发现两处神经根受伤。只有一种损伤（L4）与螺钉的位置错误有关。结论：这项研究表明，经皮椎弓根螺钉插入腰椎是一种安全可靠的技术。尽管错位发生率仅为6.6％，但应记住，外科手术对技术要求很高，应仅由经验丰富的脊柱外科医师进行。

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