计算机导航与C臂透视下颈椎弓根置钉的实验研究  

An experimental study of computer navigation and c-arm fluoroscopy for pedicle screw placement in lower cervical spine

作　　者：吴登将[1] 杨进顺[2] 陈为坚 WU Deng-jiang;YANG Jin-shun;CHEN Wei-jian(Department of Orthopaedics,the Fifth Affiliated Hospital of Guangzhou Medical University,Guangdong Province,Guangzhou 510700,China;Department of Orthopaedics,the Second Affiliated Hospital of Guangzhou Medical University,Guangdong Province,Guangzhou 510260,China)

机构地区：[1]广州医科大学附属第五医院骨外科,广东广州510700 [2]广州医科大学附属第二医院骨外科,广东广州510260

出　　处：《中国当代医药》2018年第18期64-67,共4页China Modern Medicine

摘　　要：目的对术中计算机导航与普通C臂透视辅助下颈椎弓根置钉精确性的对比实验研究。方法筛选出2013年6月~2016年6月我校解剖教研室提供的经甲醛浸泡过成人颈椎标本(C_1~T_1)16个,要求保留完整的后方、侧方结构,CT扫描排除骨质疏松、椎弓根结构细小不能置钉的标本,随机分为两组。1组标本在普通C型臂X线机正侧位透视下进行C_2~C_7实体置钉,另1组标本在术中计算机导航辅助下置入椎弓根螺钉。术后行CT扫描、三维重建颈椎椎弓根,评估置入螺钉的精确性。结果普通C臂透视下置入螺钉96枚,优60枚(62.5%),可20枚(20.8%),差16枚(16.7%);计算机导航辅助下置入螺钉96枚,优88枚(91.7%),可6枚(6.2%),差2枚(2.1%)。两种置入颈椎螺钉方法的成功率比较(83.3%vs.97.9%),差异有统计学意义(P<0.05)。结论计算机导航法置钉较普通C臂透视下置钉准确性有明显提高。Objective To compare the accuracy of intraoperative computer navigation and ordinary C-arm fluoroscopy in the placement of lower cervical pedicle screws.Methods Altogether 16 formalin-soaked adult cervical specimens(C1-T1)that were provided by Teaching and Research Section of Anatomy in our school from June 2013 to June 2016 were selected.The integrity of the posterior and lateral structure was required to be retained.CT scan was used to exclude specimens with osteoporosis and small pedicle screw structure that were unable to perform screw placement.The specimens were randomly divided into two groups,among which a group of specimens were placed in the C2-C7 entity under the positive lateral fluoroscopy of the normal C-arm machine;and another group of specimens were inserted into the pedicle screw under the guidance of intraoperative computer navigation.The CT scan and 3D reconstruction of the vertebral pedicle were performed to evaluate the accuracy of the screw placement.Results Altogether 96 screws were implanted under the fluoroscopy of C-arm,among which 60(62.5%)were excellent,20(20.8%)were good,16(16.7%)were bad.And 96 screws were implanted by using computer navigation,among which 88(91.7%)were excellent,6(6.2%)were good,2(2.1%)were bad.The success rate of two kinds of cervical screw insertion methods was compared(83.3%vs.97.9%),with statistically significant difference(P<0.05).Conclusion Compared with the conventional C-arm fluoroscopy,the accuracy of screw placement by using computer navigation is obviously improved.

关 键 词：计算机导航 C臂透视 颈椎 椎弓根螺钉 

分 类 号：R687.1[医药卫生—骨科学]