胸腰段椎弓根置钉的术中三维实时导航△

Intraoperative three-dimensional real-time navigation for thoracolumbar pedicle screw placement

摘要:

［目的］评估术中三维实时导航系统辅助植钉技术的影像结果。［方法］2016 年 3 月—2019 年 3 月，62 例患者接受胸腰椎椎弓根钉固定术，术中随机选择一侧采用三维实时导航置钉，另一侧采用徒手置钉。采用 Rampersaud 的标准对影像椎弓根钉置入的准确性进行评估比较。［结果］ 62 例患者共置钉 204 枚。胸椎 62 枚，置钉准确率导航辅助侧为 93.55% （29/ 31），徒手侧为 77.42% （24/31），两侧差异有统计学意义 （P<0.05）。腰椎 142 枚，置钉准确率导航辅助侧为 97.18% （69/71）， 徒手侧为 80.28%（57/71），差异有统计学意义（P<0.05）。［结论］胸腰椎弓根置入采用三维实时导航系统辅助技术，显著提高了置钉的精确性。

Abstract:

[Objective] To evaluate the imaging outcomes of intraoperative three- dimensional real-time navigation assisted pedicle screw placement. [Methods] From March 2016 to March 2019, 62 patients underwent thoracolumbar pedicle screw fixation. During the op- eration, one side was randomly selected to use three-dimensional real-time navigation screw placement, while the contralateral side had screw placed by conventional freehand technique. The accuracy of pedicle screw placement on images was evaluated and compared be- tween the two sides. [Results] A total of 204 screw were placed in 62 patients. Of the 62 screws in thoracic vertebrae, the screw placement accuracy rate was 93.55% (29/31) on the navigation assisted side, while 77.42% (24/31) on the freehand side, which was statistically signifi- cant (P＜0.05) . Of the 142 screws in lumbar vertebrae, the accuracy of screw placement was 97.18% (69/71) on the navigation assisted side, whereas 80.28% (57/71) on the freehand side, with a statistically significant difference between the two sides (P＜0.05) . [Conclusion] The intraoperative three-dimensional real-time navigation does considerably improve the accuracy of pedicle screw placement