Engtin nge pedicle screw te hi an dah thin?

Pedicle screw dah dan tur

1. Entry point: a kawr, a rilru leh a kawr a inang lo;

2. Screw entry-a horizontal plane angle (TSA) leh sagittal plane angle (SSA) te 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 control theih a ni.

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

4. A sei zawng: needle insertion point atanga vertebral body hmalam cortex sei zawng zawng atanga 83% thleng.

Cervical Spine a ni

Cervical pedicle screw hmanga dah dan

Needle dah dan tur

Tunah hian needle insertion hmanraw lian ber berte chu: Abumi method, anatomical landmark positioning method, computer-aided imaging positioning method, etc. te hi an ni.

cervical spine luhna hmun a ni

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

• C3-C6 Side block hnung lama upper middle 1/4 horizontal line leh middle outer 1/4 vertical line inkar.

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

  
  

Cervical vertebra chu a screwing angle a ni

• C2 incline 20-25° incline 10-15° a ni

• C3-C6 incline 40-45°, horizontal plane chu upper leh lower endplate nen parallel a ni

• C7 inclination 30-40°, horizontal plane chu upper leh lower endplate nen parallel a ni

  
  

Cervical spine screw hmanga siam a ni

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

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

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

Cervical lateral mass screw hmanga dah a ni

Magerl-a hman dan : Screw entry point hi lateral mass hnunglam wall midpoint atanga 1-2mm a sangah a awm a; screw luhna lam chu 25-30° laterally inclined a ni a, lu chu 30° tilted (upper articular surface nen parallel) a ni a, contralateral cortex chu drilled a ni depth measurement 3.5mm cortical bone screws screw hnuah.

Roy-Camille method : screw luhna hmun chu lateral mass hnunglam lai takah a awm a; screw luhna lam chu 10° laterally a ni a, vertical posterior cortex chu drill a ni a, contralateral cortex chu drill a ni bawk; sounding zawhah 3.5mm cortical bone screw chu screw in a ni.

Anderson-a hman dan : Screw luhna hmun chu lateral mass lairil chhungah 1mm-ah dah a ni a, screw luhna lam chu laterally-ah 20° a ni a, lu chu 20° atanga 30°-a tilt-in hole drill a ni a, contralateral cortex chu drill a ni.

Experience chungchang tawi te te

(1) Screw implantation hi a him leh him loh 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) Hmanraw hian pedicle pawn lam bang a luhchilh thei lo va, chuti lo chuan a kianga awm nerve leh thisen kalna kawngte a tichhia ang.

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

(5) Vertebral body hmaa cortical bone penetration loh tur a ni.

(6) Intraoperative fluoroscopy hmang hian vertebral body leh intervertebral space chu dik takin a hmu thei a, intervertebral space leh spinal canal-a screw lut lo turin screw dik takin a dah thei bawk.

Thoracic a ni

Needle luhna hmun:

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

2. Ebraheim chuan T1-T2 pedicle lairil chu superior articular process pawn lam kil chhungah mm 7-8 vel a awm a, transverse process midline-ah mm 3-4 vel 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 inkar chu nail entry point a ni.

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

5. Thil harsa takah chuan lamina thenkhat lakchhuah a, direct vision hnuaia pedicle screw dah hi duhthlanna him tak a ni.

Thoracic spine dahna tur angle

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

Upper thoracic vertebrae-a pedicle screw-te chu sagittal plane nen 10-20° inclination angle an nei tur a ni a, middle leh lower thoracic vertebrae-a pedicle screw-te chu sagittal plane nen 0-10° inclination angle an nei tur a ni. Ebraheim chuan T1 leh T2 pedicle screw te chu sagittal plane nen 30-40° inclination a ni tur a ni a, T3-T11 chu 20-25° a ni tur a ni a, T12 chu 10° a ni tur a ni tih a rawt a.

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

Thoracic spine thlan theihna screw

• T1～T5 hian screw diameter 3.5～4.0mm a mamawh

• T6～T10 hian 4.0—5.0mm a mamawh

• T11, T12 te hian 5.5mm an mamawh

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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-ah hian screw mm 5 aia lian chu dah theih a ni lo va, hei hian awlsam takin pedicle rupture a thlen thei a ni.

Mithiam thenkhat chuan pedicle lateral placement an hmang a, hei hian he harsatna hi a chinfel sak tha hle. Transverse process tip chu click la, pin chhungah lut 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 chunglam thlengin degree a sang zauh zauh a ni.

Screw dah luh hian transverse process, costotransverse process thenkhat, costovertebral joint leh vertebral body lateral wall te a paltlang ang. Screw dahna kawng hi facet joint pawnah a awm avangin spinal canal chhungah luh theih a ni lo a, chu chu a him zawk. Chu bakah, inclination angle a san chuan screw chu a sei zawk bawk. , a thuk zawk a, fixation chakna a sang a, implantation angle range a lian a, screw te chu line-ah dah theih a ni a, assembly pawh a awlsam zawk.

Lumbar ruhro (lumbar spine) a ni

Lumbar luhna hmun a ni

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

3. Thil buaithlak takah chuan lamina thenkhat lakchhuah a, direct vision hnuaia pedicle screw dah hi duhthlanna him tak a ni.

Lumbar screw angle a ni

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

• Horizontal plane angle : L1-4: a tawp ber nen a inmil a; L5: Degree 10 hnuai lam hawi (L5 vertebral body hnunglam hawi).

  
  

Lumbar spine thlan theihna screw

• L1～L5 hian screw diameter 6.5mm, 40-45mml screw a mamawh

  
  

Surgery chungchanga fimkhur dan tur

1. Surgery hma hian lumbar spine hi hmalam leh a sir lam atanga thlir dan chiang tak a awm tur a ni. Anterior view-ah hian screw awmna chu horizontal direction-ah a lang a, lateral view-ah chuan screw awmna chu vertical position-ah a lang thei bawk.

2. Entry point chu a dik leh a remchan dan angin a lian tur a ni a, anchor point-a cortical bone chu triangular pyramid emaw rongeur emaw hawn hmangin lakchhuah theih a ni.

3. General direction i hriat zawh hnuah chakna tling hmangin circuit chu uluk takin hawng ang che. Blunt-tip probe hian needle dah laiin dodalna chiang tak a tawk tur a ni lo. 'hlawhchhamna' tih hriatna emaw, dodal nghal mai emaw a awm tur a ni lo. 5~15mm hmasa berah resistance kan tawk a nih chuan a hun takah a ni tur a ni. Needle luhna hmun leh angle chu siamrem rawh. Resistance chak tak i tawk a nih chuan chhuak hmasa la, luhna tur lam chu thlang leh la, a tha. Pedicle kal dan tur chu zawm ngei ang che. Pedicle chhung lam chu cancellous bone a ni a, pawn lam chu cortical bone a ni a, chu chu relatively automatically guided a ni thei a, chu chu entry point dik tak leh a tihpun dan tur dik tak a nih phawt chuan Midline-ah 10-15° inher la, vertebral body chunglam kil nena inmil plane chu ngaihven la, 3cm vel thuk chu man rawh. Feel a pawimawh.

4. Pedicle probe hmanga bang pali, a bik takin inner, lower leh bottom wall te probe a pawimawh hle.

5. Lower thoracic leh lumbar vertebrae inkara anatomical distinction a chiang lo chuan accessory process leh lower articular process chu bite off la, chutah chuan upper articular process chu a then chu bite off la, pedicle chhung lam bang leh pedicle luhna lam chu direct-in en rawh.

6. Chhung lam ai chuan pawn chhuah a tha zawk, chho leh chhuk loh a tha zawk; rotation hi a pawimawh ber a, hmalam chu supplement a ni bawk; hmasawn leh probing laiin, i hmuh nasat hunah ding la, a hun takah insiamrem la, kut zungtang chakna chauh hmang la, chak takin twist suh.

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

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