基于O-arm~的计算机辅助导航技术在单开门颈椎管扩大成形术中应用的临床评价  

Application of computer-assisted navigation technology based on O-arm~ in unilateral open-door cervical expansive laminoplasty:analysis of 26 cases

作　　者：徐闯 张亚庆 黄博 周跃 XU Chuang;ZHANG Yaqing;HUANG Bo;ZHOU Yue(Department of Orthopedics,Second Affiliated Hospital,Army Medical University (Third Military Medical University),Chongqing,400037,China)

机构地区：[1]陆军军医大学(第三军医大学)第二附属医院骨科,重庆400037

出　　处：《第三军医大学学报》2018年第24期2254-2259,共6页Journal of Third Military Medical University

摘　　要：目的探究应用基于O-arm的计算机辅助导航技术在单开门颈椎管扩大成形术中应用的可行性,并对其临床效果进行评价。方法收集2014年5月至2017年10月,在我科应用基于O-arm的计算机辅助导航技术行单开门颈椎管扩大成形术治疗颈椎管狭窄症的患者26例,男性21例,女性5例;年龄33～76岁,平均59. 4岁。根据日本骨科协会(Japanese Orthopaedic Association,JOA)评分(17分法)及其改善率评价术后神经功能改善情况。根据术后6个月复查影像学结果评价椎管扩大情况及门轴侧骨融合情况。结果患者手术时间(162. 2±24. 0) min,术中出血量(282. 7±117. 0) m L,术中未出现相关并发症。患者术后随访时间6. 0～46. 4个月,平均22. 8个月,术前JOA评分8. 1±2. 7,末次随访JOA评分13. 4±2. 7,所有患者临床症状均有不同程度改善(P <0. 05),术后改善率(58. 2±30. 4)%。患者术后6个月患者影像学资料提示椎管扩大满意,门轴侧均见骨性融合,未出现再关门情况及神经损害加重的情况。结论应用基于O-arm的计算机辅助导航技术开展单开门颈椎管扩大成形术,其手术方式安全可行,临床效果令人满意。Objective To explore the feasibility of computer-assisted navigation technology based on O-arm■ in unilateral open-door cervical expansive laminoplasty and evaluate its safety and therapeutic effect in patients with cervical spinal stenosis. Methods From May 2014 to October 2017, 26 patients with cervical spinal stenosis, including 21 male and 5 female patients with a mean age of 59.4 years (range 33-76 years), underwent unilateral open-door cervical expansive laminoplasty in our department with computer-assisted navigation technology based on O-arm■. The postoperative neurological improvement of the patients was evaluated by assessing the Japanese Orthopedic Association (JOA) score (17 points) and the improvement rate. All the patients underwent imaging examinations at 6 months after the operation to assess postoperative spinal canal enlargement and bone fusion on the hinge side. ResultsThe mean operation time was 162.2±24.0 min in these cases with a mean intraoperative blood loss of 282.7±117.0 mL; no complications occurred during the operation. All the patients were followed up for 6.0-46.4 months (mean 22.8±10.5 months). The mean JOA score of the patients before the operation was 8.1±2.7, which increased to 13.4±2.7 at the final follow-up. All the patients showed significant improvements of the clinical symptoms (P<0.05) with a mean improvement rate of (58.2±30.4)%. At 6 months after operation, all the patients, except for 1 patient who was lost to the follow-up, showed satisfactory enlargement of the spinal canal and bony fusion on the hinge side without recurrence of cervical stenosis or neurofunction deterioration. Conclusion Unilateral open-door cervical expansive laminoplasty with computer-assisted navigation technology based on O-arm■ is safe and feasible and can achieve satisfactory therapeutic effect for treatment of cervical spinal stenosis.

关 键 词：颈椎管狭窄症 O-arm■ 计算机导航 椎管扩大成形术 单开门 

分 类 号：R318.6[医药卫生—生物医学工程] R616[医药卫生—基础医学]