自制颈椎椎弓根导航模板辅助椎弓根螺钉置入准确性的评估  

TO EVALUATE THE ACCURACY OF PEDICLE SCREW PLACEMENT ASSISTED BY SELF-MADE CERVICAL PEDICLE SCREW NAVIGATION TEMPLATE

作　　者：史玉林[1] 李志卫 潘洪发 王炳武[1] 刘伟强[1] 于明东[1] SHI Yulin;LI Zhiwei;PAN Hongfa;WANG Bingwu;LIU Weiqiang;YU Mingdong(Department of Spinal Surgery,Weifang People’s Hospital,Weifang 261041,China)

机构地区：[1]潍坊市人民医院脊柱外科

出　　处：《精准医学杂志》2019年第5期437-440,共4页Journal of Precision Medicine

基　　金：山东省科技发展计划项目(2012YD18115);潍坊市科技发展计划项目(2015WS025、2016YX002)

摘　　要：目的利用3D打印实物模型自行设计出一种新型个体化颈椎椎弓根置钉导航模板,观察评估其辅助颈椎椎弓根螺钉置入的准确性。方法选取于2014年8月—2018年5月在潍坊市人民医院脊柱外科二区行颈椎后路手术并在潍坊市人体脊柱生物力学学科重点实验室行3D打印的患者椎体实物模型,选取其无异常的颈椎节段共36节,自行设计相应节段的椎弓根导航模板,设计完成后在实物模型上进行导航模板辅助下相应的椎弓根置钉,根据通用的方法评估置钉的准确性。结果使用颈椎节段36节,共置入72枚椎弓根螺钉,平均置钉时间为(5.39±0.89)min,Ⅰ类螺钉65枚,Ⅱ类螺钉6枚,Ⅲ类螺钉1枚,模拟置钉可接受准确率为98.6%。结论自制颈椎椎弓根导航模板制作简单,辅助颈椎椎弓根螺钉置入的准确率较高,可使颈椎手术更安全,有良好临床应用价值。Objective To design a new type of individualized cervical pedicle screw navigation template using a 3D-printed physical model,and to evaluate the accuracy of cervical pedicle screw placement assisted by this navigation template.Methods The patients who underwent posterior occipital and cervical surgery in Second District of Department of Spinal Surgery,Weifang People’s Hospital,from August 2014 to May 2018 and underwent 3D printing in Weifang Key Laboratory of Human Spine Biomechanics were enrolled.A total of 36 normal segments of the cervical vertebrae were selected,and a pedicle screw navigation template was designed for each segment.Pedicle screw placement was performed on a physical model with the assistance of the navigation template,and a general method was used to evaluate the accuracy of screw placement.Results A total of 72 pedicle screws were placed for the 36 segments of the cervical vertebrae,with a mean time of screw placement of(5.39±0.89)min.There were 65 classⅠscrews,6 classⅡscrews,and 1 classⅢscrew,and the acceptance accuracy of screw placement was 98.6%.Conclusion The self-made cervical pedicle screw navigation template is simple to make and has a high accuracy in assisting cervical pedicle screw placement,which increases the safety of cervical spine surgery and has high value in clinical practice.

关 键 词：颈椎 椎弓根钉 外科手术 计算机辅助 打印 三维 

分 类 号：R605[医药卫生—外科学] R319.1[医药卫生—临床医学]