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1、·494·JournalofPracticalOrthopaedicsVol.10,No.6,Dec.2004文章編號(hào):1008-5572(2004)06-0494-03TSRH釘棒結(jié)構(gòu)在脊柱側(cè)凸后路矯正中的應(yīng)用阮永平,徐榮明,周雷杰,胡 勇(寧波市第六醫(yī)院骨科,浙江寧波 315040) 摘要:目的 探討釘棒結(jié)構(gòu)治療脊柱側(cè)凸的可行性和臨床效果。方法 應(yīng)用TSRH釘棒結(jié)構(gòu)治療各種脊柱側(cè)凸22例,術(shù)前平均Cobb角62°,22例術(shù)前均對(duì)畸形脊柱進(jìn)行標(biāo)準(zhǔn)俯臥位CT加密掃描,測(cè)量入釘點(diǎn)至椎體前緣的深度和椎體的旋轉(zhuǎn)角度,根據(jù)測(cè)得數(shù)據(jù)確定椎弓根螺釘置入的深度和方向,術(shù)后
2、再次行CT掃描,評(píng)價(jià)置釘?shù)臏?zhǔn)確性。結(jié)果 經(jīng)3～14個(gè)月隨訪(fǎng),術(shù)后Cobb角平均18°,矯正率為72.5%;平均手術(shù)時(shí)間3h20min,平均出血量1050mL,無(wú)感染,無(wú)神經(jīng)并發(fā)癥,無(wú)假關(guān)節(jié)形成,置釘準(zhǔn)確率96.8%。結(jié)論 術(shù)前采用標(biāo)準(zhǔn)俯臥位CT掃描,根據(jù)掃描圖象測(cè)得的相關(guān)數(shù)據(jù)可為術(shù)中準(zhǔn)確置入椎弓根螺釘提供重要參考。釘棒結(jié)構(gòu)具有良好的三維矯正控制力,由于內(nèi)固定部件較少,所以同時(shí)具有操作簡(jiǎn)便、手術(shù)時(shí)間短、出血量較少,費(fèi)用較低等優(yōu)點(diǎn)。關(guān)鍵詞:脊柱側(cè)凸;后路矯正;釘棒結(jié)構(gòu);CT掃描+中圖分類(lèi)號(hào):R681.23 文獻(xiàn)標(biāo)志碼:BClinicalApplicationof
3、TSRHInstrumentationinPosteriorCorrectionofScoliosisRUANYong2ping,XURong2ming,ZHOULei2jie,HUYong(DepartmentofOrthopaedics,NingbosixthHospital,Ningbo315040,China)Abstract:ObjectiveTodiscusstheclinicaleffectandfeasibilityofTSRHinstrumentationinposteriorfixationopera2tionforscoliosis.Me
4、thods22casesweretreatedwithposteriorTSRHinstruments,theCobbangleaverage62°preopera2tive.RotativeangleofvertebraandvertebraldepthwerebemeasuredbyCTscaninproneinallcases,Depthanddirec2tionofnailsofvertebralarchwerebedecidedviameasureddata.ReviewexactnessofplacenailsbyCTscanpostopera-t
5、ive.ResultsThefollow2upperiodrangedfrom3～14months.Post2correctionthemeanCobbanglewas18°andthecorrectionratewas72.5%.Averageopertaivetimethreehoursandtwentyminutes,averagebleed1050mL.Therewerenoinfection,nopseudarthrosisandnoneurologicalcomplication.Exactnessrateofplacenailswas96.8%.
6、Conclu2sionRotativeangleofvertebraandvertebraldepthwerebemeasuredbyCTscaninpronepreoperative,measureddataweresevedasreliancewhichplacednailsofvertebralarch.Structureofnail2stickhasexcellentcorrectivefunctionofthree2dimension,TSRHwaseasyhandlingandeasyoperating,furthermoreithavemanya
7、dvantagessuchascheaper,lessbleedandshortertime.Keywords:scoliosis;post2correction;structureofnail2stick;CTscan 目前在脊柱側(cè)凸后路矯正中大多數(shù)學(xué)者都主張使用鉤柱正側(cè)位,左右正位片,以評(píng)估側(cè)凸程度及側(cè)凸的柔軟性。棒結(jié)構(gòu)或僅在腰段使用釘棒結(jié)構(gòu),這主要是由于胸椎椎弓根1.2CT掃描 所有病人術(shù)前均行手術(shù)范圍內(nèi)的脊柱節(jié)段釘?shù)膽?yīng)用存在潛在的危險(xiǎn)性,同時(shí)椎體旋轉(zhuǎn)畸形使得椎弓根CT加密掃描,以測(cè)量入釘點(diǎn)至椎體前緣的深度和椎體的旋螺釘?shù)臏?zhǔn)確置入非常困難。雖然釘棒結(jié)構(gòu)
8、屬于三維矯正系轉(zhuǎn)角度,了解椎弓根的大小
