导航模板辅助置入枢椎椎弓根螺钉的临床应用

Clinical Application of Navigational Drill Template for the C2 Pedicle Screw Implantation

目的:评价导航模板辅助置入枢椎椎弓根螺钉的准确性和安全性。方法:2013年7月-2015年7月对13例需要行枢椎椎弓根螺钉置入手术的患者,术前根据三维重建图像,利用计算机辅助设计及三维打印技术设计制作枢椎及其椎弓根螺钉置入导航模板,术中应用导航模板辅助置入枢椎弓根螺钉26枚,术后CT扫描评价螺钉位置,记录有无与螺钉置入相关的并发症。结果:术中共应用13个个体化导向模板,辅助植入枢椎椎弓根螺钉26枚。术后X线观察及CT断层扫描显示所有螺钉进钉点准确,进钉方向适当。枢椎椎弓根螺钉准确性分级:0级24枚,Ⅰ级2枚。结论:导航模板辅助置入枢椎椎弓根螺钉,准确率高,安全可行。

Objective To evaluate the accuracy and safety of navigational drill templates for C2 pedicle screw implantation.Methods From July 2013 to July 2015,there were 13 patients received C2 pedicle screw implantation. Before the surgery,volumetric CT scanning was performed and the data were collected.Then three-dimensional（ 3D） images of axis were reconstructed and the optimal trajectory of pedicle screw was designed using computer aided design softwares. The drill template and physical models of axis were manufactured by 3D printing technology.The positions of C2 pedicle screws were assessed by x-ray and CT scanning after surgery.The complications related to screw implantation were also recorded.Results Total 13 navigational drill templates were manufactured and 26 C2 pedicle screws were implanted by using the drill templates. CT scanningshowed that the starting point was right and the direction was appropriate after surgery.The accuracy of C2 pedicle screw was grade 0 in 24 screws and gradeⅠ in 2 screws.Conclusion It is a safe and accurate way to insert C2 pedicle screw by using the navigational drill templates.