| 张超,阮狄克,何勍,文天用,吕游.O形臂导航辅助、C形臂辅助与常规徒手置入胸腰椎椎弓根螺钉准确性的定量比较[J].脊柱外科杂志,2020,18(2):73-76. |
O形臂导航辅助、C形臂辅助与常规徒手置入胸腰椎椎弓根螺钉准确性的定量比较  点此下载全文 (Fulltext) |
| 张超 阮狄克 何勍 文天用 吕游 |
| 解放军总医院第六医学中心骨科, 北京 100048 |
| 基金项目： |
| DOI：10.3969/j.issn.1672-2957.2020.02.001 |
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| 摘要： |
| 目的 比较O形臂导航辅助、C形臂辅助与常规徒手置入胸腰椎椎弓根螺钉的准确性。方法 回顾性分析2015年2月-2018年12月应用椎弓根螺钉系统辅助融合治疗的129例胸腰椎置钉患者术后CT资料，其中胸腰段以下脊柱骨折41例，退行性疾病88例。常规开放手术直视下徒手置钉（徒手组）42例，C形臂辅助下经皮置钉（C形臂组）46例，开放手术O形臂导航辅助下置钉（O形臂组）41例。从螺钉长度、横断面进钉角度、矢状位进钉角度、椎弓根内侧壁、椎弓根上下壁、椎弓根外侧壁6个方面，采用10分制定量评估椎弓根螺钉置钉准确性，记录得分情况并进行组间比较。结果 共置钉712枚。徒手组置钉准确性评分为7.79±0.93，满分比例为7.7%（16/208）；C形臂组评分为9.13±0.59，满分比例为51.0%（101/198）；O形臂组评分为9.27±0.65，满分比例为62.1%（190/306）。C形臂组和O形臂组置钉准确性评分差异无统计学意义（P>0.05），但均高于徒手组，差异有统计学意义（P<0.05）。结论 C形臂辅助经皮置钉和O形臂导航辅助置钉的准确性优于传统徒手置钉，C形臂辅助经皮置钉与O形臂导航辅助置钉准确性相当。 |
| 关键词：胸椎 腰椎 骨钉 计算机辅助设计 成像，三维 |
| Quantitative comparison of accuracy between O-arm navigation assisted,C-arm assisted and free-hand thoracolumbar pedicle screw placements Fulltext |
| ZHANG Chao RUAN Di-ke HE Qing WEN Tian-yong Lü You |
| Department of Orthopaedics, Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China |
| Fund Project: |
| Abstract: |
| Objective To compare the accuracy of O-arm navigation assisted,O-arm navigation assisted and conventional free-hand pedicle screw placements. Methods A total of 129 patients underwent thoracolumbar pedicle screw placement by free-hand(n=42),O-arm navigation assisted(n=41) or C-arm assisted(n=46) technique for degenerative diseases(88 cases) or spinal fracture(41 cases) from February 2015 to December 2017 were enrolled in the study. The accuracy of inserted pedicle screws was assessed postoperatively by using of high-resolution spiral computed tomography imaging. Screw placement was scored on 6 graded parameters:screw length;axial and sagittal trajectory;medial,sagittal and lateral breaches. Ten possible points were given for each pedicle screw. Data collected for comparison of accuracy between 3 groups were statistically analyzed. Results A total of 712 screws were placed for all the patients. The pedicle screw accuracy score in the free hand group was 7.79±0.93 and 7.7%(16/208) of implanted screws received full scores(10 score),which were 9.13±0.59 and 51.0%(101/198) in the C-arm group,and 9.27±0.65 and 62.1%(190/306) in the O-arm group. There was no significant difference between the C-arm and O-arm group in the accuracy score,but both of them were higher than that of the free-hand group,and the differences were statistically significant(P<0.05). Conclusion An optimal screw position can be achieved with a greater accuracy through both O-arm navigation and C-arm assisted technique than free-hand placement,and the accuracy scores of the O-arm group and the C-arm group are similar. |
| Keywords:Thoracic vertebrae Lumbar vertebrae Bone nails Computer-aided design Imaging,three-dimensional |
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