神经导航技术在脊柱固定手术中的应用(附16例报告)

Vertebral bone fixation with the help of neuronavigation.

目的探索使用神经导航技术进行脊柱内固定。方法在神经导航辅助下,对16例患者置入70根椎弓根(侧块)螺钉。通过术后X线摄片核实椎弓根螺钉置入的准确性。结果置入的70根椎弓根(侧块)螺钉长度和直径选择合适,其中68根(97·1%)固定位置及方向准确;早期曾有1根穿出至椎体前方(<1mm),未作处理;1根穿出至椎间盘,经翻修后固定情况良好。无神经和血管损伤症状。结论使用神经导航技术,可以前瞻性地判断置入椎弓根(侧块)钉的大小、位置,实时监测置入过程,提高置入的准确性和安全性。术中脊柱影像三维重建及注册配准对神经导航的准确性有较大影响。

Objective The method of inner spine fixation with the assistance of neuronavigation was explored. Methods With the assistance of neuronavigation, 70 pedicle （ lateral mass） screws were implanted in 16 patients. The accuracy of implanting was checked by postoperative x-ray image. Results Seventy implanted pedicle （ lateral mass） screws were selected in proper length and diameter, of which 68 screws were implanted accurately in site and direction. One screw pierced vertebral body anteriorly not more than 1 mm, was not dealt with. One inserted intointervertebral disc, was repaired and fixed well. No symptom of neural and vascular damage was found. Conclusions With the help of neuronavigation the screws size and location could be imagined previously, the procedure of implantation was monitored to improve the accuracy and safety. Intraoperative 3-D spine image reconstruction and registration, pairing are considered to play an important role in the accuracy of navigation.