胸腰段椎弓根置钉的术中三维实时导航

Intraoperative three-dimensional real-time navigation for thoracolumbar pedicle screw placement

[目的]评估术中三维实时导航系统辅助植钉技术的影像结果。[方法]2016年3月—2019年3月,62例患者接受胸腰椎椎弓根钉固定术,术中随机选择一侧采用三维实时导航置钉,另一侧采用徒手置钉。采用Rampersaud的标准对影像椎弓根钉置入的准确性进行评估比较。[结果]62例患者共置钉204枚。胸椎62枚,置钉准确率导航辅助侧为93.55%(29/31),徒手侧为77.42%(24/31),两侧差异有统计学意义(P<0.05)。腰椎142枚,置钉准确率导航辅助侧为97.18%(69/71),徒手侧为80.28%(57/71),差异有统计学意义(P<0.05)。[结论]胸腰椎弓根置入采用三维实时导航系统辅助技术,显著提高了置钉的精确性。

[Objective]To evaluate the imaging outcomes of intraoperative three-dimensional real-time navigation assisted pedicle screw placement.[Methods]From March 2016 to March 2019,62 patients underwent thoracolumbar pedicle screw fixation.During the op⁃eration,one side was randomly selected to use three-dimensional real-time navigation screw placement,while the contralateral side had screw placed by conventional freehand technique.The accuracy of pedicle screw placement on images was evaluated and compared be⁃tween the two sides.[Results]A total of 204 screw were placed in 62 patients.Of the 62 screws in thoracic vertebrae,the screw placement accuracy rate was 93.55%(29/31)on the navigation assisted side,while 77.42%(24/31)on the freehand side,which was statistically signifi⁃cant(P<0.05).Of the 142 screws in lumbar vertebrae,the accuracy of screw placement was 97.18%(69/71)on the navigation assisted side,whereas 80.28%(57/71)on the freehand side,with a statistically significant difference between the two sides(P<0.05).[Conclusion]The intraoperative three-dimensional real-time navigation does considerably improve the accuracy of pedicle screw placement.