三维C形臂导航系统与CT导航系统引导下腰椎弓根穿刺的比较

Comparison of 3D C-arm fluoroscopy-based and CT-based navigation systems in the lumbar pedicle puncture:in vitro experiment on a cadeveric lumbar trunk specimen

目的比较三维 C 形臂导航系统与 CT 导航系统在腰椎弓根穿刺中的准确性与操作特点。方法按照各导航系统操作要求,在同一腰椎标本上,同时在三维 C 形臂与 CT 导航引导下进行了 L3、L4和 L5的椎弓根穿刺,穿刺过程中同时用 C 形臂 X 线透视机进行实时检测,判断导航的准确性。总结两种导航系统的在各个环节的操作特点及其优缺点。结果两种导航系统在引导椎弓根穿刺上均具有非常高的准确性,但操作过程各有其特点。结论两种导航系统均具有其独到的优势,三维 C 形臂导航操作比较便捷迅速,尤其适合于经皮穿刺操作。CT 导航设备要求相对较少,图像清晰,更适合骨质疏松的椎体。

Objective To compare the accuracy and operating features of 3D C-ann fluoroscopybased and CT-based navigation systems in the lumbar pedicle punctures. Methods A specimen of cadaveric lumbar trunk underwent lumbar pedicle punctures at the levels of L3, IA, and L5 under the guidance of the 3D C-ann fluoroscopy-based and CT-based navigation systems. During the procedure C-ann fluoroscopy was used to monitor the accuracy of the puncture. Generally, in comparison with the 3D C-ann fluoroscopy-based navigation system, the best operation route and protocol could be drawn up preoperatively, matched registration needed to be renewed for each vertebra, and the images thus obtained were of high quality in CT-based navigation. Results Both navigation systems had excellent accuracy in the guidance of lumbar pedicle punctures, and had different operating features. Conclusion Both navigation systems had its special advantages. The operating process of the 3D C-ann fluoroscopy-based navigation system was more convenient and rapid, and suitable for percutancous vertebral puncture. CT based navigation system had clearer pictures, especially for the ostcoporotic vertebral bodies, and it had less requirements for the equipments.