Spinal screws are used for internal fixation of thoracolumbar spinal fractures or spinal orthopedics and are commonly used for internal fixation of the vertebral arches. Patients with spinal injuries, spinal deformities, spinal deformities and other spinal abnormalities exercise pedicle internal fixation with less postoperative incisional damage, better treatment results and faster recovery.
Spinal pedicle entry point and direction
The cervical spine is divided into pedicle screws and lateral block screws
Upper cervical spine.
Pivotal pedicle screws: nail entry point 7-8 mm inwards at the outer edge of the lateral block and 9-10 mm at the lower edge of the inferior articular eminence. orientation: 25° abduction. Handle tilted caudally 25°.
Lower cervical spine.
C3-C7 pedicle screws.
Point of entry: outer edge of lateral block 5 mm inwards, lower edge of inferior articular eminence 2 mm downwards. orientation: 45° abduction; subvertical to surface of lateral block
Upper cervical spine: (lateral block screws)
Point of entry: 2-3mm above the inferior edge of the C2 inferior articular eminence, 2-3mm lateral to the medial edge of the C2-3 tuberosity. orientation: 0-10° towards the midline, pointing forward to the midpoint of the anterior atlantoaxial tuberosity
Lower cervical spine: (lateral block screws)
Point of nail entry: 1-2mm medial and cephalad or medial and cephalad 1/3 of the midpoint of the articular eminence; orientation: angled 30° anterolaterally and parallel to the articular surface of the articular eminence
Thoracic pedicle screws.
T2-T11 pedicle screws: remove the cortex below the outer articular eminence with a biting forceps or probe the base of the upper articular eminence directly below the inferior articular eminence margin, with the nail entry point just
T1 and T12 pedicle screws: the entry point for T1 should be slightly inward, with a reduced inward angle of the screw trajectory; for T12, the entry point is in the mastoid process and the inward angle of the trajectory should be increased, in the same way as the entry point for lumbar pedicles.
Lateral thoracic pedicle screws.
nail entry point at the tip of the transverse process, at the level of the midline of the transverse process, in a direction that intersects the lateral margin of the lesser trochanter, forming an angle of 25°-40°; the nail entry angle gradually increases from T12 upwards.
Lumbar pedicle screws.
Point of nail entry: intersection of the lateral edge of the superior articular process and the transverse process axis. Orientation: angle of nail tail abducted at approximately 15° in the axial plane
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