网格定位板在经皮椎弓根微创手术进钉点定位中的应用  

Application of spinal localizer in preoperative localization for minimally invasive percutaneous pedicle screw fixation

作　　者：易国良[1] 宋西正[1] 王文军[1] 姚女兆[1] 

机构地区：[1]南华大学附属第一医院,湖南省衡阳市421001

出　　处：《中国组织工程研究》2017年第15期2366-2371,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(81272055)~~

摘　　要：背景:微创经皮椎弓根螺钉内固定技术具有出血少、肌肉及软组织剥离少、术后恢复快等优点,而经皮椎弓根进针点定位是手术成功的关键。目的:探讨自制网格定位板在经皮椎弓根微创手术进钉点定位中的应用价值。方法:纳入2009年3月至2015年3月在南华大学附属第一医院接受胸腰椎段后路经皮椎弓根微创手术的患者428例,患者在经皮椎弓根微创手术前随机应用网格定位板或传统定位法(髂嵴定位、肋骨定位、伤椎形态定位、皮肤标志物定位、克氏针定位和穿刺针定位法)进行术前进针点定位,比较不同定位方法的定位准确率、定位时间及透视次数。结果与结论:(1)网格定位板定位法定位准确率优于传统定位法(P<0.05);定位时间短于传统定位法(P<0.05);定位过程中透视次数少于传统定位法(P<0.05)。网格定位板在脊柱经皮椎弓根微创手术中前定位的定位准确率、定位时间、透视次数均优于传统定位法;(2)结果表明,网格定位板法与传统定位法比较,具有定位准确率高、定位时间短、透视次数少等优点,在经皮椎弓根微创手术进针点定位中具有一定的优势。BACKGROUND： Minimally invasive percutaneous pedicle screw fixation possesses the advantages of less blood loss, less muscle and soft tissue dissection, and rapid recovery; however, accuracy of the screw positioning is the key to be successful.OBJECTIVE： To explore the application value of self-designed spinal localizer in the screw positioning for minimally invasive percutaneous pedicle screw fixation.METHODS： 428 patients with thoracolumber disorders were subjected to minimally invasive percutaneous pedicle screw fixation at the First Affiliated Hospital of University of South China, from March 2009 to March 2015, and randomly underwent the preoperative screw positioning by self-designed spinal localizer or one of traditional localizing methods （iliac crest, ribs, symptomatic vertebral appearance, skin marker, Kirscher wire, puncture needle localizations）. The location accuracy, positioning time and radiographic times were compared among methods.RESULTS AND CONCLUSION： （1） Compared with the traditional localization methods, the self-designed spinal localizer was superior in accurate rate （P 〈 0.05）, cost less positioning time （P 〈 0.05） and received less radiation （P 〈 0.05）. （2） To conclude, the self-designed localizer exhibits a certain application value, which is an ideal method in preoperative localization for minimally invasive percutaneous pedicle screw fixation.

关 键 词：骨钉 内固定器 组织工程 骨科植入物 脊柱植入物 经皮椎弓根 术前定位 网格定位板 国家自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]