三维CT重建辅助胸椎椎弓根钉置入的实验研究  

EXPERIMENTAL STUDY OF THREE-DIMENSIONAL CT RECONSTRUCTION FOR THORACIC PEDICLE SCREW PLACEMENT

作　　者：范子文[1] 谢楚海[1] 黄彦[1] 黄文铎[1] 

机构地区：[1]广州医学院第二附属医院,广东广州510260

出　　处：《现代医院》2012年第1期16-19,共4页Modern Hospitals

基　　金：广东省医学科研基金资助项目(编号:A2010257)

摘　　要：目的探讨三维CT重建辅助技术在胸椎椎弓根钉置入术中的应用价值。方法选择四具胸椎标本(T1～T12),CT扫描后行三维重建,测量各具标本胸椎解剖数值及三维重建后椎弓根进钉点各定位数据。将4具胸椎标本分为两组,由同一位具有一定胸椎椎弓根螺钉置钉经验的骨外科医师分别以徒手法及根据三维重建后定位数据指导置入胸椎椎弓根螺钉。CT扫描比较两种方法的置钉准确性。结果导航模板法和徒手法各置入96枚螺钉。对两种方法的置钉准确率及风险螺钉发生率进行比较,三维CT重建辅助下的置钉准确率高于徒手法,风险螺钉发生率低于徒手法,差异有统计学意义(P<0.05)。结论三维CT重建辅助下胸椎椎弓根各解剖参数量化后,置钉准确率高,为胸椎椎弓根螺钉置入提供了一种新的方法。Objective To explore the application and outcomes of preoperative three - dimensional CT reconstruction for thoracic pedicle screws placement. Methods Four thoracic cadavers specimens were divided into two groups for CT navigation and bare - handed. CT scans were performed to evaluate the three - dimensional anatomic data. All screws were implanted by the same orthopedic surgeon with transpedicular screw placement experiences in thoracic spine placement. 96 thoracic screws were inserted respectively by navigation or bare - handed method. CT scans were performed to evaluate screw exit rates and orientation rel- ative to the pedicle axis. The relative position of the screw to the pedicle was graded. Results The accuracy rate of screw placement in the CT navigation group is higher compared with the bare - handed group, while the incidence of the risk of the screw misplace is lower than that of bare - handed method with statistical sig- nificance （p 〈 0.05）. Conclusion Transpedicular screw placement assisted by preoperative three - dimen- sional CT reconstruction guide in thoracic spines may be used as a novel method for its advantage of safety, feasibility and screw placement accuracy.

关 键 词：胸椎 CT重建 椎弓根钉 

分 类 号：R683[医药卫生—骨科学]