eFilm影像工作站辅助PVP及PKP术前计划及术中定位的临床应用

Application of eFilm workstation in the preoperative plan,intraoperative location and postoperative evaluation of PVP and PKP

目的:评估eFilm影像工作站应用于经皮椎体成形术(PVP)及经皮椎体后凸成形术(PKP)术前计划及术中定位的可行性及有效性。方法:2006年10月至2007年10月,对行PVP或PKP治疗的20例患者在术前使用eFilm影像工作站辅助术前计划及术中定位。术前先用eFilm影像工作站设计出预定的进针通路,记录进针点、进针角度及进针深度,术中直接按上述参数进针。术前记录预定针尖位置距椎体中线及椎体前壁的距离,再与术中正侧位X线透视所测得的实际针尖距椎体中轴线及椎体前壁的距离做比较,计算差值,取差值最大的一个参与最终评价,差值5mm以下为优,5～10mm为良,10mm以上为差。结果:20例手术均成功完成,无骨水泥渗漏发生。针尖距椎体中线的距离与术前预测值的差值为0～6mm,平均为3±1mm。针尖距椎体前壁的距离与术前预测值的差值为0～8mm,平均为4±1mm。最终评价优15例,良5例,差0例。结论:eFilm影像工作站可为PVP及PKP手术提供准确可靠的进针点、进针角度及进针深度等参数,术中依上述参数操作可使骨穿针到达预定位置。eFilm影像工作站应用于PVP及PKP的术前计划及术中定位可行且有效。

Objective：To evaluate the feasibility and efficacy of eFilm workstation in percutaneous vertebroplasty （PVP） and kyphoplasty （PKP）.Method：The study group included 20 patients who underwent PVP or PKP with eFilm workstation for preoperative plan, intraoperative location and postoperative evaluation.In preop- erative plan,a needling access was designed first,and then the entering point,depth and angle of the needle were determined and recorded,on which needllng was performed during the operatlon.The distance between the designed location of the needle tip and the midline of the vertebral body,and the anterior wall of the vertebral body was determined and recorded repectively in advance,which was compared with those obtained through anteroposterior and lateral fluoroscopy during operation,and their differences were used to evaluate the accuracy.The accuracy was graded as excellent （〈Smm）,good （Smm to 10mm） and poor（〉10mm）.Result：All procedures were completed successfully,and there were no intraoperative or postoperative complications.The difference of the distance between the needle tip and the midline of the vertebral body in both predetermined and real records was 3±1mm（range,0 to 6mm）,and the difference of the distance between the needle tip and the anterior wall of the vertebral body in predetermined and real records was 4±1mm （range,0 to 8mm）.15 patients were rated as excellent,5 patients as good,and no patient as poor.Conclusion：eFilm workstation can provide accurate and realible parameters of the entering point,depth and angle of a needle in advance for PVP and PKP,following which the needle can be placed as it was planned,it is an effective tool for the preoperative plan and intraoperatlve location in PVP and PKP.