Applied research about modified method of vertebral plate stress line and articular facet as a reference mark of pedicle screw insertion
JIANG Chuan-jie, YANG Yong-jun, ZHOU Ji-ping, YANG kai, WU Rui, TAN Yuan-chao
Chinese Journal of Clinical Anatomy ›› 2016, Vol. 34 ›› Issue (5) : 490-494.
Applied research about modified method of vertebral plate stress line and articular facet as a reference mark of pedicle screw insertion
Objective To study the modified method of pedicle screw insertion. Methods 205 cases of spinal disorders, including thoracic, cervical and lumbar disorders, were randomly divided into two groups and underwent surgery to insert pedicle screw. Pedicle screw insertion method of group A was determined by the traditional method and group B was by the modified method, using the vertebral plate stress line and articular facet as a reference mark. Intraoperative and postoperative X-ray, CT and intraoperative nerve dissector touch inspection were adopted to determine the insertion accuracy. One-time success rate of pedicle screw insertion was calculated to compare which determination method was more successful. Results Success rates of traditional method and the modified method were respectively 80.7% and 96.5% (P<0.001), among which 78.1% and 95.5% (P＝0.002) were in cervical spine surgery, 82.4% and 95.9% in thoracic surgery (P<0.001), 80.3% and 97.0% in lumbar spine surgery (P<0.001). Conclusion The modified method using vertebral plate stress line and articular facet as a reference mark of pedicle screw insertion has a higher success rate of insertion. As stress line and articular facet respectively representing the stress conduction of the vertebral body, the modified pedicle insertion method showed a great application value and could realize individualized pedicle screw insertion.
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