数字化虚拟手术系统在胸腰椎骨折治疗中的应用价值

Value of digital virtual surgery system in surgical treatment of thoracolumbar vertebral fracture

目的探讨数字化虚拟手术系统(digital virtual surgery system,DVSS)在治疗胸腰段骨折中的应用价值并验证其准确性。方法 2008年3月—2011年6月,对113例胸腰段单椎体爆裂型Denis B型骨折患者采用传统后路短节段经伤椎置钉行复位固定(A组)。2012年3月—2014年9月,对128例胸腰段单椎体爆裂型Denis B型骨折患者术前应用DVSS模拟骨折复位,制定最佳手术方案后行后路短节段经伤椎置钉(B组),手术方式与A组相同。比较2组病例手术时间、术中透视时间、术中出血量、椎弓根侧壁及椎体前方骨皮质穿破情况。结果 2组均无感染、血肿发生。B组在手术时间、术中透视时间、椎弓根钉穿破椎弓根侧壁与椎体前方骨皮质方面均优于A组,差异有统计学意义(P<0.05)。2组出血量相比,差异无统计学意义(P>0.05)。2组病例均未发生其他不良后果。结论应用DVSS辅助脊柱外科手术具有操作简便、安全性高、精确度可信的临床效果,而且便于推广。

Objective To discuss the core value of digital virtual surgery system（DVSS）,and verify its accuracy in the treatment of thoracolumbar vertebral fracture. Methods From March 2008 to June 2011,113 patients of burst Denis B thoracolumbar fractures were treated with traditional posterior short segment internal fixation（Group A）. From March 2012 to September 2014,128 patients of burst Denis B thoracolumbar fractures were treated with traditional posterior short segment internal fixation with the best operation plan designed by DVSS simulated operation（Group B）. Comparison was made in the operation time,intra-operative perspective time,blood loss and penetration condition on lateral wall of vertebral pedicle and anterior cortex between the 2 groups. Results There was no infection and hematoma in both groups. The operation time,intraoperative perspective time and penetration condition on lateral wall of vertebral pedicle and anterior cortex in Group B were all better than those of Group A（P 0.05）. There was no significant difference in blood loss of the 2 groups（P 0.05）. Other adverse outcomes did not occur in the 2 groups. Conclusion The application of DVSS in spinal surgery has the advantages of simple procedures,high safety,accuracy and clinical reliability,which leads to wide popularization.