椎弓根螺钉导航模板在上颈椎手术中的应用  

The use of pedicle screw navigational template in upper cervical surgery

作　　者：卢腾[1] 李浩鹏[1] 臧全金[1] 贺西京[1] 

机构地区：[1]西安交通大学第二附属医院骨科,陕西西安710004

出　　处：《生物骨科材料与临床研究》2015年第6期29-32,36,I0009,共6页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨上颈椎手术中椎弓根螺钉导航模板(Pedicle screw navigational template,PSNT)辅助椎弓根螺钉(Pedicle screw,PS)植入的准确性和可行性。方法回顾性分析我科室收治的12例上颈椎畸形患者。术前根据患者上颈椎CT平扫数据获得个体化PSNT,并在手术过程中使用PSNT辅助PS的植入。术后观察患者CT平扫图像中PS与椎弓根和骨皮质的位置关系,并判断螺钉位置的优劣等级。结果 12例患者共放置34枚PS 34枚,其中20枚置入C_2、8枚置入C_3、2枚置入C_4、2枚置入C_5。PS位置Ⅰ级31枚(91.2%)、Ⅱ级2枚(5.9%)、Ⅲ级1枚(2.9%)、Ⅳ级0枚。优良率为97.1%。结论在上颈椎手术中,PSNT为一有效可靠的导航方法,且能够显著降低术中电离辐射的暴露时间。值得在上颈椎手术中开展应用。Objective To evaluate the accuracy and feasibility of Pedicle Screw Navigational Template（PSNT） using in upper cervical Pedicle Screw（PS） instrumentation. Methods We retrospectively analyzed the outcomes of 12 upper cervical deformed patients. Preoperatively, the CT scan data was obtained from the patients. Base on the CT data, the patient specific PSNT was constructed. Intraoperatively, the PSNT was used to help insert the PS. After the operation,the position relationship between the PS and the pedicle was measured from the CT images. Results A total of 34 PSs were inserted. Among these screws, 31 were classified as grade Ⅰ（91.2%）, 2 were classified as grade Ⅱ（5.9%）, 1 was classified as grade Ⅲ（2.9%） and none were classified as grade Ⅳ（0%）. Conclusion In upper cervical surgery, PSNT is and effective and feasible navigational method. Besides, it can significantly reduce the radiation exposure to the patient and surgeons. Bases on these factors, the PSNT is worth to be popularized and applied in upper cervical surgery.

关 键 词：上颈椎畸形 导航模板 3D打印 椎弓根螺钉 

分 类 号：R687.3[医药卫生—骨科学]