The Dangerous Blind Spot of Intraoperative Lateral Fluoroscopy for Transpedicular Screw Implantation

以側位放射線透視為引導放置經椎腳鋼釘時，有一因從椎腳入口至椎體前骨皮質之距離與顯現於側向x光片上距離之差異所造成之盲點。故當外外科醫師以側位放射線透視為引導放置經椎腳鋼釘時，可因此盲點之誤導而穿破椎體前骨皮質而傷到大血管，這可導致極大之危險。沿著椎腳軸線測量前後距離，除T11及T12外，此距離明顯地較前後垂直距離為長，故作者建議放置經椎腳鋼釘時，除T11及T12外，應沿椎腳軸線放置，即稍向內偏，於T11、T12處應垂直放置但應選擇較側向x光片所顯示距離為短的鋼釘為宜。

關鍵字

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並列摘要

There is a radiographic blind spot encountered intraoperatively during transpedicular screw inserting by use of lateral fluoroscopy,i.e the difference between the real straight distance from posterior entrance of pedicle to anterior vertebral body cortex and the distance shown on the lateral radiograph. Therefore while a surgeon inserts transpedicular screws straightly with aid of intraoperative lateral fluoroscopy, the transpedicular screw may be misleaded and injure the paramedianly located great vessels on account of inadvertently penetrating the anterior vertebral body cortex. This is a disaster. The distance to the anterior cortex is significantly the greatest along the pedicle axis at all levels except T11 and T12. The author recommends implantation of transpedicular screw should be along the pedicle axis,i.e.slight medially deviated, rather than straight anterior insertion. At T11 and T12 levels, screw insertion should be straight and the screw length shorter than the length measured from the lateral radiograph should be chosen.

並列關鍵字

transpedicular screw ； lateral fluoroscopy ； pedicle

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The Dangerous Blind Spot of Intraoperative Lateral Fluoroscopy for Transpedicular Screw Implantation

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