应力传导分析联合术中导航椎弓根置钉

Pedicle screw placement by stress conduction analysis technique combined with intraoperative navigation

[目的]通过术中导航技术验证采用应力传导分析方法确定腰椎椎弓根置钉路径的可行性及精准性。[方法]2019年06月-2020年08月,对132例患者行腰椎椎弓根钉内固定。其中,66例采用应力传导分析方法确定置钉路径并结合术中导航技术置钉(联合组)。66例采用常规导航技术置钉(导航组)。比较两组早期临床与影像资料。[结果]两组患者顺利完成手术,其中联合组共置钉264枚,导航组共置钉264枚。两组术中出血量、手术时长、切口长度差异无统计学意义(P>0.05),但是联合组首次置钉成功率显著高于导航组(P<0.05)。两组置钉准确性Rampersaud分级以及矢状位、横断位偏移角度的差异均无统计学意义(P>0.05)。[结论]以应力传导分析方法确定腰椎椎弓根置钉路径可行性高,并可提高首次置钉成功率。

[Objective]To verify the feasibility and accuracy of lumbar pedicle screw placement path based on stress conduction analysis technique by comparing with intraoperative navigation.[Methods]From June 2019 to August 2020,132 patients underwent lumbar pedicle screw for internal fixation.Among them,66 patients had pedicle screw placed following the path determined by stress conduction analy-sis technique combined the intraoperative navigation(combined group),while the remaining 66 patients were by using conventional navigation only(the navigation group).The early clinical and imaging data were compared between the two groups.[Results]The patients in both groups had operation completed successfully,with 264 pedicle screws placed in the combined group,whereas 264 screws in the navigation group.There was no significant difference in intraoperative blood loss,operation time,and incision length between the two groups(P>0.05),but the combined group had significantly higher success rate of screw placement on the first time than the navigation group(P<0.05).There were no statistically significant differences in the accuracy of pedicle screw placement based on Rampersaud classification,the deviation angles in the sagittal and transverse planes between the two groups(P>0.05).[Conclusion]It is feasible to determine the path of lumbar pedicle screw placement by stress conduction analysis method,which improves the success rate of screw placement on the first time.