新型腰5进钉点椎弓根螺钉置钉方法的临床研究(附手术视频)
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南京医科大学第一附属医院骨科,江苏 南京 210029

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R687.3

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江苏省重点研发计划(产业前瞻与共性技术)项目(BE2018132)


Clinical study on a new L5 entry point for pedicle screw placement(with surgical video)
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Department of Orthopedics,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029 ,China

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    摘要:

    目的: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,以改进腰5椎体椎弓根螺钉置入技术。方法:选取2020年6月—2023年12月南京医科大学第一附属医院需行腰5椎弓根螺钉内固定的患者60例, 分为新型进钉组(Novel组,30例)和传统Magerl法组(Magerl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:Novel组置钉满意率为95%,显著高于Magerl组80%(P=0.013)。两组患者手术时间、术中出血量、透视剂量差异均无统计学意义(P > 0.05)。结论:新型腰5进钉点可显著提高置钉精度,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 from June 2020 to December 2023 were enrolled and divided into two groups:the novel group(30 patients)and the traditional Magerl group(30 cases). Two groups each inserted 60 L5 pedicle screws. Screw placement accuracy was evaluated using the Gertzbein and Robbins classification system. Outcomes including satisfactory rate of screw placement,intraoperative fluoroscopy 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 Magerl group(80%,P=0.013). No significant intergroup differences were observed in operative time,intraoperative blood loss, fluoroscopy exposure dose(P > 0.05). No neurological complications occurred in either group. Conclusion:The novel L5 entry point significantly improved screw placement accuracy without increasing surgical risks,demonstrating potential for clinical application.

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陈研松,徐寅阳,伏佳驹,李青青,眭涛,曹晓建.新型腰5进钉点椎弓根螺钉置钉方法的临床研究(附手术视频)[J].南京医科大学学报(自然科学版),2025,45(9):1301-1306

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  • 收稿日期:2025-01-07
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  • 在线发布日期: 2025-09-11
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