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A new free-hand pedicle screw placement technique with reference to the supraspinal ligament

The Journal of Biomedical Research 2014年第1期28卷 64-70页

作者： Juming Li Hong Zhao Hao Xie Lipeng Yu Jifu Wei Min Zong Feng Chen Ziqiang Zhu Ning Zhang Xiaojian Cao Department of Orthopaedics the First Affiliated Hospital of Nanjing Medical University Department of radiology the First Affiliated Hospital of Nanjing Medical University Department of Statistics Nanjing Medical University

We sought to compare the safety and accuracy of a new free-hand pedicle screw placement technique to that of the conventional technique. One hundred fifty-three consecutive adult patients with simple fracture in the tho- racic or/and lumbar spine were alternately assigned to either the new free-hand or the conventional group. In the new free-hand technique group, preoperative computerized tomography （CT） images were used to calculate the targeted medial-lateral angle of each pedicle trajectory and the pedicle screw was inserted perpendicular to the corresponding supraspinal ligament. In the conventional technique group, the medial-lateral and cranial-caudal angle of each pedicle trajectory was determined by intraoperatively under fluoroscopic guidance. The accuracy rate of pedicle screw placement, the time of intraoperative fluoroscopy, the operating time and the amount of blood loss during operation were respectively compared. All screws were analyzed by using intraoperative ra- diographs, intraoperative triggered electromyography （EMG） monitoring data, postoperative CT data and clinical outcomes. The accuracy rate of pedicle screw placement in the new free-hand technique group and the conven- tional technique group was 96.3% and 94.2% （P 〈 0.05）, respectively. The intraoperative fluoroscopy time of the new technique group was less than that of the conventional technique group （5.37 seconds vs. 8.79 seconds, P 〈 0.05）. However, there was no statistical difference in the operating time and the amount of blood loss during op- eration （P 〉 0.05）. Pedicle screw placement with the free-hand technique which keeps the screw perpendicular to the supraspinal ligament is an accurate, reliable and safe technique to treat simple fracture in the thoracic or lum- bar spine.

关键词： spine fracture pedicle screw placement radiation exposure supraspinal ligament anatomy reference

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Observation of therapeutic effects on supraspinal ligament impairment treated with fire needling

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World Journal of Acupuncture-Moxibustion 2009年第2期19卷 13-16页

作者：周立武北京市昌平区中医医院针灸按摩科

Objective To compare the therapeutic effect of fire needling with that of medication on supraspinal ligament impairment. Methods One hundred and sixty cases were randomly divided into 2 groups. Of which, in fire needling group （80 cases）, fire needling was applied and Ashi points （choosing the spinous processes of the affected vertebras as the central points） were selected. In western medicine group （80 cases）, medication was applied with Nabumetone capsules for oral administration. Two groups were treated for 2 courses and the therapeutic effects were evaluated 4 weeks after the treat- ment. Results The total effective rate was 96.3% in the fire needling group and 67.5% in the western medicine group, indicating a significant difference in comparison of the 2 groups （P〈0.05）. Conclusion The therapeutic effect of fire needling is much superior to that of medication therapy on supraspinal ligament impairment.

关键词： Fire Needling supraspinal ligament Impairment

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