Engtin nge pedicle screw te hi an dah thin?

Pedicle screw dah dan tur .

1. A luhna hmun: Kawng, rilru leh kawrfual a danglam a;

2. Screw entry a horizontal plane angle (TSA) leh sagittal plane angle (SSA) chu man rawh: TSA angle hi CT film atang hian teh theih a ni. SSA hian taksa dinhmun nen inzawmna engemaw tak a nei a, operation neih chhung hian C-ARM hmangin a control theih bawk.

3. Depth: Screw sei zawng hian pedicle axis sei zawng 80% a thleng a, chu chuan biomechanical strength tling tak a hmu thei a, cortical bone chhunga lut a, a sei lutuk chuan thisen kalna kawng a tichhia a awlsam hle.

4. A sei zawng: Needle insertion point atanga vertebral body anterior cortex sei zawng zawng 83% thleng.

Cervical spine .

Cervical pedicle screw dah dan tur .

Needle dah dan tur .

Tunah hian needle dah dan ber chu: Abumi method, anatomical landmark positioning method, computer-aided imaging positioning method, etc.

Cervical spine luhna hmun .

• C2 axis lamina chunglam kil horizontal line hnuai lam 5mm leh spinal canal medial edge pawn lam 7mm inkar ah.

• C3-C6 A chung lam middle 1/4 horizontal line leh side block hnung lama middle outer 1/4 vertical line inzawmna.

• C7 Lateral block-a vertical midline leh upper middle 1/4 horizontal line inkar chu a chungah a awm a.

  
  

Cervical vertebra screwing angle a ni.

• C2 Incline 20-25° A rilru a buai em em a, a rilru a hah em em bawk.

• C3-C6 incline 40-45°, a horizontal plane chu a chung leh a hnuai endplates nen a inmil a ni .

• C7 inclination 30-40°, horizontal plane chu a chung leh a hnuai endplates nen a inmil a ni .

  
  

Cervical spine screw 1000 a ni.

• C1～C5 hian screw diameter 3.5mm leh a thuk zawng 20mm a mamawh a ni .

Atlas posterior arch san zawng chu 4mm aia tlem a nih chuan lateral mass screw-ah a inthlak a ni.

Axis pedicle san zawng emaw a zau zawng emaw chu 5mm aia tlem a nih chuan lateral mass screw fixation-ah thlak a tha.

Cervical lateral mass screw dahna tur .

Magerl’s Method : Screw luhna hmun hi lateral mass hnunglam bang laihawl atanga 1-2mm a sangah a awm a; Screw luhna lam chu 25-30° laterally inclined a ni a, a lu chu tilted 30° (a chung lam articular surface nen a inang) a ni a, contralateral cortex chu drilled a ni a 3.5mm cortical bone screw-a screw-a screwing hnua depth tehna.

Roy-Camille Method : Screw luhna hmun hi lateral mass hnunglam lai takah a awm a; Screw luhna lam chu 10° laterally a ni a, vertical posterior cortex chu drilled a ni a, contralateral cortex chu drilled a ni a Sounding hnuah 3.5mm cortical bone screw a screw lut a.

Anderson’s Method : Screw entry point chu lateral mass lairil chhungah 1mm a awm a, screw entry direction chu 20° laterally-ah a awm a, a lu chu 20° atanga 30°-ah a hole drill turin a tilt a, contralateral cortex chu drilled a ni.

Experience summary 1000 a ni.

(1) Screw implantation himna tur ngaihtuah bik tur a ni. Surgeon chuan cervical anatomy leh pedicle screw technique thiamna a zirin a hman dan tur dik tak a thlang tur a ni.

(2) C3-C6 segment-a lateral mass screw fixation hi pedicle screw fixation aiin a awlsam zawk a, a him zawk bawk.

(3) Hmanrua chuan pedicle pawn lam bang chu a luhchilh thei lo va, chuti lo chuan a bula nerve leh thisen kalna kawngte chu a tichhia ang.

(4) Screw dahna angle chu vertebral arch angle a zirin a danglam tur a ni.

(5) Vertebral body hmaa cortical bone lut tur chu pumpelh tur a ni.

(6) Intraoperative fluoroscopy hian vertebral body leh intervertebral space chu dik takin a hmu thei a, intervertebral space leh spinal canal-a screwing awm loh nan screw dik takin a dah thei bawk.

thoracic a ni.

Needle luh theihna hmun:

1. Margel leh Roy Camille te chuan transverse process midpoint-a horizontal line leh superior articular process pawn lam edge vertical line chu entry point atan an la a.

2. Ebraheim chuan T1-T2 pedicle center chu superior articular process pawn lam kil chhungah 7-8 mm a awm a, transverse process midline-ah 3-4 mm a awm tih a rawt a. ~8mm a ni.

3. Lower joint midpoint pawnah vertical line 3 mm siam la, transverse process base chunglam 1/3 atang chuan horizontal line siam la, line pahnih inzawmna chu nail entry point a ni.

4. Inferior articular process-a longitudinal axis midline leh transverse process root-a midpoint-a horizontal line, facet hnuai lam 1 mm

5. Complex case-ah chuan lamina thenkhat lakchhuah leh direct vision hnuaia pedicle screw dah te hi duhthlan tur him tak a ni.

Thoracic spine insertion angle .

Sagittal plane : T1 atanga T12 thlenga pedicle inclination tlahniam. T1: 25°; T2: 20°; T3: 15°; T4-9: 10° a ni a; T10: 5°; T11-12: 0° a ni.

Thoracic vertebrae chunglam pedicle screw te hian sagittal plane nen inclination angle 10-20° a nei tur a ni a, a lai leh a hnuai lam thoracic vertebrae te pedicle screw te chu sagittal plane nen inclination angle 0-10° a nei tur a ni. Ebraheim chuan T1 leh T2 pedicle screw te chu sagittal plane nen 30-40° inclination a nih tur thu a rawt a, T3-T11 chu 20-25° a ni tur a ni a, T12 chu 10° a ni tur a ni.

Horizontal plane : A chung leh a hnuai endplate te nen a inmil tur a ni.

Thoracic spine thlan tur screw .

• T1～t5 hian screw diameter 3.5～4.0mm a mamawh a ni.

• T6～t10 A mamawh 4.0—5.0mm

• T11, T12 hian 5.5mm a mamawh a ni.

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Puitling tan chuan thoracic pedicle screw diameter hi 5mm aia tlem a ni a, screw a chhe thei bawk. Mid-thoracic spine tam takah chuan screw 5 mm aia lian chu dah theih a ni lo va, chu chuan awlsam takin pedicle rupture a thlen thei a ni.

Mithiam thenkhat chuan pedicle lateral placement an hmang a, chu chuan he harsatna hi a chinfel sak tha hle. Pin chhunga lut tur chuan transverse process tip kha click la, transverse process midline chu horizontal a ni. Hole te tak te chu han herh hmasa la, AWL lam hawi chu vertebra facet joint lateral edge nen a inzawm ang. Sagittal plane nena angle chu 25-40 degree a ni a, T12 atanga sang chhoin degree chu a sang chho zauh zauh bawk.

Screw dah luh chu transverse process, costotransverse process atanga a then, costovertebral joint, leh vertebral body lateral wall te a paltlang ang. Screw insertion route chu facet joint pawnah a awm avangin spinal canal chhungah a lut thei lo a, chu chu a him zawk a ni. Chu bakah, inclination angle a san chuan screw chu a sei zawk bawk. , thicker, fixation strength a sang a, implantation angle range a lian a, screw te chu line khatah dah theih a ni a, assembly pawh a awlsam zawk.

Lumbar spine 1000 a ni.

Lumbar luh theihna hmun .

1. Herringbone ridge apex-a needle insertion method (accessory process ridge-a superior articular process root-a accessory process ridge-a meeting point leh isthmus ridge-a awm chu, he position-a danglamna chu a tlem (a thlen rate chu 98%) a ni a, positioning-in accessory process chu a bit a ni.

2. Intersection method: facet joint pawn lama transverse process leh longitudinal axis-a transverse axis midline inzawmna, emaw, superior articular process pawn lam kil emaw,

3. Complex case-ah chuan lamina thenkhat lakchhuah leh direct vision hnuaia pedicle screw dah te hi duhthlan tur him tak a ni.

Lumbar screw angle a ni a.

• Sagittal plane angle : L1-L3 hian 5-10 degree inversion a nei a, L4-L5 hian 10-15 degree inversion a nei bawk.

• Horizontal plane angle : L1-4: Endplate nena inmil; L5: 10 degree hnuai lam hawia inclination (L5 vertebral taksa hnunglam hawi).

  
  

Lumbar spine thlan tur screw .

• L1～l5 mamawh screw diameter 6.5mm, 40-45mml screw a mamawh a ni.

  
  

Surgery lama fimkhur tur .

1. Surgery hmain lumbar spine hmalam leh lateral view chiang tak a awm tur a ni. Anterior view ah chuan screw awmna chu horizontal direction-ah a awm a, lateral view chuan vertical position-a screw awmna hmun a tarlang thei bawk.

2. Entry point chu a dik a, a remchan dan angin a lian tur a ni a, anchor point-a cortical bone chu triangular pyramid emaw rongeur emaw hawnna hmangin a chhuak thei bawk.

3. General direction i hriat hnuah, circuit chu uluk takin hawn theih turin force dik tak hmang ang che. Blunt-tip probe hian needle insertion laiin resistance langsar tak a tawk tur a ni lo. 'a hlawhchhamna' emaw, a do let nghal mai emaw a awm tur a ni lo. 5~15mm hmasa bera resistance a awm chuan a hun takah a ni tur a ni. Needle entry point leh angle te chu siam tha rawh. Resistance chak tak i tawk a nih chuan chhuah hmasak phawt a tha a, a luh theihna tur direction chu re-select leh a tha. Pedicle lam hawi chu zawm ngei ngei tur a ni. Pedicle chhung chu cancellous bone a ni a, a pawn lam chu cortical bone a ni a, chu chu a relatively automatically guided theih a ni a, mahse entry point chu a dik a, a ti lian tha a nih chuan Incline 10-15° midline-ah chuan vertebral body chunglam kil nena inmil plane chu ngaihven la, 3cm vel thuk chu man rawh. Feel hi a pawimawh hle.

4. Pedicle probe hmanga bang pali, a bik takin a chhung lam, hnuai lam leh hnuai lam bang te chhui chian a pawimawh hle.

5. Lower thoracic leh lumbar vertebrae inkara anatomical distinction chu a chiang lo a, accessory process leh articular process hnuai lam chu a seh a, chutah chuan a chunglam articular process chu a then a seh a, pedicle chhung lam bang leh pedicle luhna chu a en nghal a ni.

6. In chhunga luh ai chuan pawn lama chhuah a, chhuk loh a tha zawk; Rotation hi a pawimawh ber a, forward hi supplement a ni a; Advancing leh probing laiin, hard i hmuh chuan ding la, a hun taka adjust la, finger force chauh hmang la, forcefully twist suh.

7. Screw diameter chu pedicle pawn lam cortex diameter 83% aia tam lo tur a ni.

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