新型腰5进钉点椎弓根螺钉置钉方法的临床研究
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南京医科大学第一附属医院

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江苏省重点研发计划(产业前瞻与共性技术)项目


Clinical Study on a New L5 Entry Point for Pedicle Screw Placement
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Jiangsu Province Key R&D Program (Industry Prospects and Common Technologies) Project

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    摘要:

    目的:本研究旨在改进腰5椎体椎弓根螺钉置入技术,提出一种新型腰5进钉点,并通过与传统Magerl法置钉进行对比,验证其可行性与准确性。 方法:选取了南京医科大学第一附属医院60名需腰5椎弓根螺钉内固定的患者,分为新型进钉组(新型组,30例)和传统Magerl法组(传统组,30例)。两组各置入60枚腰5椎弓根螺钉,采用Gertzbein和Robbins提出的分类法来评估置钉准确性。比较两组间置钉满意率、术中透视剂量、手术时间、术中出血量和术后有无神经根侵犯症状。 结果:新型组置钉满意率为95%(57/60),显著高于传统组80%(48/60)(P=0.013)。两组患者手术时间 (183.93±40.00 vs. 193.33±55.05 min)、术中出血量(334.09±218.43 vs. 318.52±253.87 mL)、透视剂量 (88.72±42.52 vs. 106.09±43.10mGy·cm2)均无统计学差异(P>0.05)。结论:新型腰5进钉点可显著提高置钉精度(95% vs. 80%, P=0.013),且未增加手术风险,具有临床应用潜力。

    Abstract:

    Objective:This study aimed to improve the L5 pedicle screw placement technique by proposing a novel entry point and validating its feasibility and accuracy compared with the traditional Magerl method.?Methods:Sixty patients requiring L5 pedicle screw fixation at the First Affiliated Hospital of Nanjing Medical University were enrolled and divided into two groups: the novel group (30 cases, 60 screws) and the traditional Magerl group (30 cases, 60 screws). Screw placement accuracy was evaluated using the Gertzbein and Robbins classification system. Outcomes including satisfactory screw placement rate, intraoperative radiation dose, operative time, blood loss, and postoperative nerve root injury symptoms were compared between the two groups.?Results:The novel group demonstrated a significantly higher satisfactory rate (95%) compared to the traditional group (80%,P?= 0.013). No significant intergroup differences were observed in operative time (183.93±40.00 vs. 193.33±55.05 min, P=0.452), intraoperative blood loss (334.09±218.43 vs. 318.52±253.87 mL, P=0.8), fluoroscopy exposure (88.72±42.52 vs. 106.09±43.10mGy·cm2, P=0.122). No neurological complications occurred in either group. Conclusion:The novel L5 entry point significantly improved screw placement accuracy (95% vs. 80%,?P?= 0.013) without increasing surgical risks, demonstrating potential for clinical application.

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  • 收稿日期:2025-01-07
  • 最后修改日期:2025-04-22
  • 录用日期:2025-08-25
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