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Jackson骶骨棒内固定技术的解剖学研究及临床应用 |
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邱勇 朱泽章 朱丽华 宋知非 骆东山 周正扬
【摘要】目的探讨Jackson骶骨内置棒行腰骶部内固定的安全性,并将其用于治疗腰骶椎滑脱患者。方法在经S1、S2神经孔的CT扫描层面上测量80名志愿者的骶骨侧块横径和侧块后外侧径，以及髂骨对骶骨后外侧部可能提供的支撑覆盖。应用该内固定技术治疗腰骶椎滑脱患者12例,滑脱百分率平均为34％。结果最小骶骨侧块横径和后外侧径分别为14.8mm和10.9mm，均明显大于Jackson骶骨棒的直径7.0mm,并且74.6％的受试者有良好的髂骨对骶骨后外侧提供的支撑覆盖。本组滑脱病例手术复位率平均72％，术后2周无外固定练习下床活动。随访6～24个月,患者腰腿痛消失，植骨呈骨性融合，无复位丢失,无断钉、断棒或内固定松动。结论Jackson骶骨棒内固定是安全可行的，对腰骶部滑脱可良好复位，术后无需卧床或外固定，近期效果满意。
【关键词】骶骨；解剖学；内固定器；脊椎前移；外科手术
Anatomical study and clinical application of Jackson intra-sacral rod fixation technique
QIU Yong, ZHU Zezhang, ZHU Lihua, et al.
（Department of Orthopaedics, Drum Tower Hospital, Nanjing 210008, China）
【 Abstract】 Objective To evaluate the safety and feasibility of the Jackson intra-sacral fixation technique by CT anatomical assessment and review the preliminary application for spondylolisthesis. Methods The sacrum of 80 randomly-selected volunteers were scanned at the level of S 1 and S 2 neuroforamina to measure the frontal diameter and the posterolateral diameter of the sacral ala, and to demonstrate the proportion of cases having the coverage of the posterolateral sacrum by the iliac crests(i.e. iliac buttressing). Jackson intra-sacral rod was used in 12 cases of lumbosacral spondylolisthesis with an average of 34％ slip. Results The smallest frontal diameter measured for the width between the sacroiliac joint and the lateral cortex of the S 1 and S 2 neuroforamina was 14.8 mm, while the smallest posterolateral diameter measured for the distance from the midpoint between the posterolateral margin of the sacroiliac joint and the lateral sacral crest to the lateral cortex of S 1 and S 2 neuroforamina was 10.9 mm. This gives adequate room for a 7.0 mm diameter rod to be inserted in the sacral ala. In 74.6％ of the cases, the iliac crests sufficiently surrounded the back of the posterolateral sacrum to offer a buttress for rods to be inserted. 12 cases of spondylolisthesis operated on wit[1] [2] [3] 下一页
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