计算机辅助导航技术在颈椎病模型前路手术的骨减压效果评估

The effects of CANS technique on decompression of cervical spondylosis models during anterior approach

目的:探讨导航技术用于指导颈椎病模型前路手术减压范围术中判定的可行性和防止椎动脉损伤的操作方法。方法:制备颈椎病的尸体骨赘模型12具,随机分为导航手术组和常规手术组,分别在计算机导航下和常规下进行颈椎前路减压手术,术前术后进行标本的三维CT扫描及重建。CT图像上测量数据,对两组数据进行比较和统计学分析。结果:(1)术前模型骨赘测量数据,两组无明显的差异。(2)椎体后缘骨赘切除比较,两组椎管矢状径恢复率和椎管面积恢复率有明显差异,椎体后缘手术范围偏差有显著差异;钩椎增生骨赘切除比较,两组神经根管面积恢复率和钩椎骨赘水平面切除率有显著差异;钩突切除效果比较,两组钩突切除边界的外缘至横突孔内缘的距离有显著差异。导航组骨减压效果优于常规组。结论:计算机辅助导航技术能够有效指导颈椎病模型前路骨减压范围,并防止椎动脉损伤,与常规手术相比导航手术操作范围更加准确、手术切除更加彻底,有很好的安全性。

Objective： To explore the effects of computer assisted navigation system （CANS） technique on decompression of cervical spondylosis models and discuss the method to prevent vertebral artery injury during anterior approach. Methods： Total 12 cadavers were made into cervical spondylosis models and divided into navigation group operated by CANS, and routine group by conventional operation randomly. 3D CT scanning was performed and calculated for analyzing the data preoperatively and postoperatively. Results： （1） The measuring indexes of models had no deviations between two groups before operation. （2） Compared to routine group, the recovery rate of sagittal diameter and canal area of CANS group was more notable after removing osteophyte of posterior border of vertebral body. The recovery rate of section area of nerve root canal and resection rate of osteophytes of uncovertebral joints on horizontal plane were different obviously between two groups after removing uncovertebral osteophytes. Two groups also had significant difference in comparison of the distance from the exterior margin of uncinate process to the posterior margin of transverse foramen. Decompression effect of CANS group was better than routine group. Conclusions： The technique of CANS was reliable in guiding the decompression during cervical spondylosis operation and protecting vertebral artery. Comparing with routine operation, CANS operation was more accurate and safely.