新型椎弓根镙钉植入定位引导系统的应用  

Application of the new pedicle screw implanted stereotactic system

作　　者：王方永[1] 李建军[1] 

机构地区：[1]中国康复研究中心北京博爱医院脊柱脊髓外科,首都医科大学康复医学院,北京市100068

出　　处：《中国组织工程研究》2012年第35期6461-6465,共5页Chinese Journal of Tissue Engineering Research

基　　金：中国康复研究中心科研基金项目(2010-12)~~

摘　　要：背景:根据脊柱解剖特点,基于三维重建图像测量的数据,设计出新型脊柱外科椎弓根镙钉定位引导系统并成功申报国家发明专利(专利号:ZL201010123475.1)。目的:初步评估一种椎弓根镙钉植入定位引导系统在椎弓根镙钉植入过程中的作用。方法:选取人体脊柱标本6例,随机分为红外导航引导置钉组和定位引导系统引导置钉组。术前CT测量使用螺旋CT机2mm厚加密扫描,对脊柱标本进行CT扫描和三维重建。根据重建模型测算各解剖标志点的参数,镙钉植入准确度分级采用Gertzbein和Robbins提出的2mm标准。结果与结论:红外导航引导置钉组共植入48枚椎弓根镙钉,其中Ⅰ级镙钉为41枚,Ⅱ级为5枚,Ⅳ级为2枚,优良率为96%。定位引导系统引导置钉组共植入48枚椎弓根镙钉,其中Ⅰ级镙钉为39枚,Ⅱ级为5枚,Ⅲ级为4枚,优良率为92%。两组镙钉植入准确性比较,差异无显著性意义(P>0.05)。说明新型脊柱外科定位引导系统引导置钉标本研究结果接近红外导航系统引导置钉。BACKGROUND： According to the characteristics of spinal anatomy and the measurement data based on the three-dimensional reconstructed image, the pedicle screw implanted stereotactic system has been designed and successfully applied for patent （patent No. ZL 201010123475.1 ）. OBJECTIVE： To investigate the application of a pedicle screw implanted stereotactic system in spine specimen operation. METHODS： Six spine specimens were selected and divided into two groups： A and B. For group A, the implantation was under the guidance of ultra-red navigation. And for group B, the new stereotactic system was used for the operation. The CT scanning and the three-dimensional reconstruction were based on 2 mm CT scanning before operation. The parameters were calculated based on the reconstructed images. The grading of screws was based on the 2 mm criteria of Gertzbein and Robbins. RESULTS AND CONCLUSION： For group A, 48 screws were implanted, and the results showed 41 screws were graded as I , 5 screws were graded as 1｜ and 2 as IV. The good rate was 96% for group A. For group B, 48 screws were implanted, and the results showed 39 screws were graded as Ⅰ , 5 as Ⅱ and 4 as Ⅲ. The good rate was 92% for group B. There was no significant difference of pedicle screws accuracy between the two groups （P 〉 0.05）. Preliminary result shows that the accuracy of the new stereotactic system is similar to that of ultra-red navigation method.

关 键 词：脊柱外科 椎弓根镙钉 植入 立体定位 引导系统 红外导航 

分 类 号：R318[医药卫生—生物医学工程]