CT测量标定穿刺路径在椎体成形术中的应用

Application of CT measuring puncture route in Percutaneous Verebroplasty

目的探索理想的椎体成形术穿刺路径和穿刺方法、提高穿刺精准性。方法椎体成形术穿刺前全部行伤椎CT扫描，根据椎弓根形态、椎弓根与椎体正中线的夹角大小，对伤椎穿刺进针路径进行CT测量标定。术中按CT测量的穿刺路径应用椎体成形穿刺导向器导引穿刺，穿刺针到位后摄伤椎正、侧位X线片，了解穿刺针位置是否符合。术后再行伤椎CT扫描观察穿刺针道是否符合。结果术中拍摄伤椎正侧位X线片与术后CT扫描穿刺针道分析显示，365个椎体节段，穿刺路径与CT测量路径符合者324节段，穿刺符合率88．8％。41节出现明显偏差，不符合率11．2％。结论CT下测量标定穿刺路径并指导穿刺在椎体成形术中的应用是有效的方法。

Objective To explore optimal puncture route and method for advance pierce accuracy when perform percutaneous vertebroplasty. Methods 248 cases （365 vertebrae ） with osteoporotic vertebral body fractures in thoracic vertebral and lumbar vertebral were treated by percutaneous vertebroplasty. Total injured vertebraes were examined and measured puncture routes under CT before operation. Then according to measure route pierce and perform percutaneous vertebroplasty, when the pricker arrived preconceive place, take some radiographs obverse and side, after operation,scan injured vertebraes with CT again. Pierce accuracy was evaluated. Results 365 vertebrae were pierced successfully,the pierce successful rate was 100%. 324 vertebra piercing route were coincident with CT measure routes, coincident rate 88.8%. 41 vertebra piercing route weren＇ t coincident with CT measure routes, deflective rate was 11.2%. Conclusion CT measure puncture route and directing pierce was effective means when percutaneous vertebroplasty.