椎弓根螺钉对于邻近关节突关节损伤的影响因素分析
Analysis of Influencing Factors of Pedicle Screws on Injury of Adjacent Facet Joints
DOI: 10.12677/acm.2024.1441062, PDF,   
作者: 许一凡, 杜 宇*：重庆医科大学附属第二医院骨科，重庆
关键词: 椎弓根螺钉；关节突关节；邻近节段退变；Pedicle Screws； Facet Joint； Adjacent Segments Degeneration
摘要: 椎弓根螺钉是常用的脊柱内固定方法，但置钉过程中可能会损伤小关节，导致小关节退变或融合，影响脊柱的功能和邻近节段的稳定性。减少术中对小关节的破坏对于减少术后邻近节段的退变具有重要意义。椎弓根螺钉置入导致小关节损伤的主要原因包括置钉方式的不同，置钉点选取差异以及椎旁软组织干扰等。此外，术中小关节损伤的发生率还受到置钉节段和解剖变异等风险因素的影响。传统的X线引导下置入螺钉容易对小关节造成损伤，而经皮椎弓根置入螺钉、开放式椎弓根置入螺钉，甚至机器人辅助下置入螺钉都能更好地保护小关节。本文分析了椎弓根螺钉置入术对邻近关节突关节损伤的危险因素，为减少关节损伤和术后并发症提供参考。
Abstract: Pedicle screws are commonly used for internal spinal fixation, but they may damage facet joints, lead to degeneration or fusion of facet joints, and affect the function of the spine and the stability of adjacent segments. Reducing the destruction of facet joints during operation is of great significance for reducing the degeneration of adjacent segments after operation. The main reasons for the injury of facet joints caused by pedicle screw implantation include different nailing methods, different nailing points and paravertebral soft tissue interference. In addition, the incidence of intraoperative joint injury is also affected by risk factors such as nailing segment and anatomic variation. Conventional X-ray guided screw placement is prone to damage to the facet joints, but percutaneous pedicle screw placement, open pedicle screw placement, and even robotic screw placement can better protect the facet joints. The risk factors of proximal facet joint injury after pedicle screw insertion were analyzed to provide reference for reducing joint injury and postoperative complications.
文章引用：许一凡, 杜宇. 椎弓根螺钉对于邻近关节突关节损伤的影响因素分析[J]. 临床医学进展, 2024, 14(4): 576-581. https://doi.org/10.12677/acm.2024.1441062

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