脊柱内固定技术的回顾与进展

CASE 5
颈椎前路钛板内固定 ORION
Spine surgery department, Guangzhou 1st municiple people,s hospital
颈椎后路内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 1
胸腰椎前路钉板内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 1
胸腰椎前路钉板内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 1
颈椎后路内固定 APOFIX
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 1
颈椎后路内固定 APOFIX
Spine surgery department, Guangzhou 1st municiple people,s hospital
胸腰椎前路内固定
CASE 1
• F，34y
胸腰椎前路钉板内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 1
胸腰椎前路钉板内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 9
颈椎后路侧块钢板内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 10
颈椎一期后路侧块钢板、前路内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
Spine surgery department, Guangzhou 1st municiple people,s hospital
3. SURGICAL TECHNIQUE
SCREW INSERTION:
AWL PROBE FEELER PROBE FINDER TAP
INSTRUMENTS: BENDING PLIERS
CASE 2
颈椎后路枕颈融合 钉棒系统内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 3
颈椎后路侧块钢板内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
ROD - SCREW LINKAGE I: INSERTER AND UNIVERSAL TIGHTENER
植骨融合内固定技术
后外侧植骨融合(椎板间、横突间）
椎间植骨-----椎间骨块 或 Cage植骨融合
后外侧植骨融合 + 椎间植骨（360º）
Spine surgery department, Guangzhou 1st municiple people,s hospital
of collapse or migration
• Donor site pain • Difficult to obtain for multiple levels
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 5
颈椎一期后路钉棒、前路钛板内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 5
颈椎一期后路钉棒、前路钛板内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 5
颈椎一期后路钉棒、前路钛板内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 5
颈椎一期后路钉棒、前路钛板内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 1
颈椎后路内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 1
颈椎后路内固定 APOFIX
Spine surgery department, Guangzhou 1st municiple people,s hospital
后外侧植骨融合(椎板间、横突间）
Spine surgery department, Guangzhou 1st municiple people,s hospital
椎间骨块 或 Cage植骨融合
• 1st Technique, developed by Cloward...
But...
• Risk
Spine surgery department, Guangzhou 1st municiple people,s hospital
脊柱矫形第二代内固定
1977 年Luque 提出了“脊柱节段性固定”的概念 增强了内固定的牢固性，但该器械缺乏纵向撑开力， 椎板下钢丝增加了脊髓损伤的风险。
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 10
颈椎一期后路侧块钢板、前路内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 4
颈椎一期后路侧块钢板、前路钛板内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 4
颈椎前路钛板内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 4
颈椎前路钛板内固定 ZEPHIR
Spine surgery department, Guangzhou 1st municiple people,s hospital
以20世纪60年代Harrington脊柱矫形内固 定器械出现为标志，脊柱内固定技术已走过40
余年的历程
Spine surgery department, Guangzhou 1st municiple people,s hospital
脊柱矫形第一代内固定
20世纪60年代Harrington器械 在将近20年间它成为了统治脊柱外科的 主要内置物
CASE 2
颈椎前路内固定，椎间Solis 固定
Design Final Cervical Cage
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 2
颈椎前路内固定，椎间Solis 固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 1
颈椎前路内固定，齿状突骨折空心钉固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 1
颈椎前路内固定，齿状突骨折空心钉固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
目前………
CD Horizon系统 TSRH系统 ISOLA系统 MOSS MIAMI系统
Spine surgery department, Guangzhou 1st municiple people,s hospital
目前………
颈椎 前路 后路 胸椎 前路 后路 腰骶椎 前路 后路
Spine surgery department, Guangzhou 1st municiple people,s hospital
脊柱内固定技术的回顾与进展
广州市第一人民医院脊柱外科
Spine surgery department, Guangzhou 1st municiple people,s hospital
温世锋
医生
Dr.WEN Shi-feng
脊柱内固定的技术水平即标志着 脊柱外科的发展水平 !
Spine surgery department, Guangzhou 1st municiple people,s hospital
Lumbar Laminar Hooks
M.A.C. Connector
脊柱矫形第三代内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
目前………
20世纪后叶， Roy-Camille经过对椎体进 行三维定量分析,获得了椎 弓根的三维定量数据 首先推出椎弓根螺钉 固定系统，是脊柱外科发 展史上的又一重要里程碑
Sublaminar Wires
脊柱矫形第三代内固定
80年代中期，Cotrel 和 Dubeosset 将棍与多种形式 的钩、椎弓根螺钉及横向螺杆相结合，发展了以CD器械为 代表的第三代脊柱内固定系统
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 3
颈椎前路内固定，椎间Solis 固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
颈椎前路钛板内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 4
颈椎一期后路侧块钢板、前路钛板内固定
Spine surgery department, GuangzhouБайду номын сангаас1st municiple people,s hospital
CASE 4
颈椎一期后路侧块钢板、前路钛板内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 2
颈椎前路内固定，椎间Solis 固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 3
颈椎前路内固定，椎间Solis 固定
G.J. Preop. MRI 30.08.2004
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 3
颈椎后路侧块钢板内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
CASE 9
颈椎后路侧块钢板内固定
Spine surgery department, Guangzhou 1st municiple people,s hospital
Implant & Instrument Overview
Spine surgery department, Guangzhou 1st municiple people,s hospital
Spine surgery department, Guangzhou 1st municiple people,s hospital