胸椎椎弓根螺钉固定矫治青少年脊柱侧凸

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目的 :探讨青少年胸椎椎弓根螺钉的固定方法及注意事项。方法 :测量 2 0例正常青少年胸椎椎弓根影像学参数 ,并在此基础上采用自行设计的胸椎椎弓根螺钉固定器械 (Scofix器械 ) ,对 32例青少年脊柱侧凸进行了矫正治疗。结果 :正常青少年T4椎弓根横径最小 ( 3 9± 0 6 6mm) ,胸椎椎弓根中点均位于横突根部上缘与中点之间 ,椎弓根与矢状面夹角在T11、T12为负角 ,T10以上为正角 ,T1最大 ( 35 8°± 0 84°)。 2 7例患者术后平均随访 11个月 ,特发性和先天性侧凸的矫正率分别为 5 7 8%和 46 4% ,无严重并发症。结论 :根据测量结果 ,如选择好进钉点、方向及深度 ,Scofix器械对青少年脊柱侧凸的矫正可获得更好的稳定性和固定强度 Objective: To discuss the methods and precautions of pediatric thoracic pedicle screw fixation. Methods: Thoracic vertebral pedicle imaging parameters were measured in 20 normal adolescents. On this basis, 32 pedicle scoliosis patients were treated by self-designed pedicle screw fixation device (Scofix instrument). Results: The diameter of T4 pedicle in normal adolescents was the smallest (39 ± 0.6 6mm), the midpoint of thoracic pedicle was located between the upper edge and midpoint of transverse root, and the angle between pedicle and sagittal plane was at T11 , T12 is negative, T10 is positive, T1 is the largest (35 8 ° ± 0 84 °). Twenty-seven patients were followed up for an average of 11 months. The corrective rates of idiopathic and congenital scoliosis were 57.8% and 46.4% respectively, with no serious complications. CONCLUSIONS: Based on the results of measurements, Scofix instruments provide better stability and firmness in the correction of adolescent scoliosis based on the selection of entry point, orientation and depth
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