三维平板透视在脊柱椎弓根螺钉置入中的应用  

Application of the vision FD vario 3D in spinal pedicle screw placement

作　　者：杜军 鲁成[1] 刘宏滨[2] DU Jun;LU Cheng;LIU Hong-bin(Section Ⅲ,Dept of Orthopaedics,the First People′s Hospital of Chuzhou City,Chuzhou,Anhui 239000,China;Section Ⅰ,Dept of Orthopaedics,the 71st Group Military Hospital of CPLA,Xuzhou,Jiangsu 221000,China)

机构地区：[1]滁州市第一人民医院骨三科,安徽滁州239000 [2]中国人民解放军第七十一集团军医院骨一科,江苏徐州221000

出　　处：《临床骨科杂志》2020年第1期28-31,共4页Journal of Clinical Orthopaedics

摘　　要：目的比较C臂机透视与三维平板透视辅助椎弓根螺钉置钉的准确性。方法将206例接受脊柱椎弓根螺钉内固定术治疗的患者根据术中透视方法不同分为对照组(C臂机透视,95例)和观察组(三维平板透视,111例)。术后行X线和CT复查,并按Richter标准比较两组椎弓根螺钉在位情况。结果共置入椎弓根螺钉916枚,观察组492枚,对照组424枚,两组比较差异无统计学意义(P>0.05)。螺钉位置优良率观察组高于对照组(P<0.05)。术后13例失访,193例患者获得随访,时间6~24个月。末次随访,104例患者取出内固定物,其余89例患者尚未取出内固定物。对照组有2例螺钉位置差的患者出现典型神经根刺激症状(下肢放射痛、麻木、无力等),下肢运动功能恢复不佳。两组均无钉、棒断裂及脱落现象。结论三维平板透视在脊柱椎弓根螺钉内固定术中的置钉准确率高于C臂机透视。Objective To compare the accuracy of pedicle screw placement between C-arm X-ray machine and vision FD vario 3D.Methods The 206 patients were divided into control group(C-arm X-ray machine,95 cases)and observation group(vision FD vario 3D,111 cases)according to different intraoperative fluoroscopy methods.According to postoperative X-ray and CT reexamination,two groups of postoperative situation of pedicle screws evaluated by the Richter standard were compared.Results Total 916 pedicle screws were implanted,492 screws were in the observation group,424 screws were in the control group,there was not statistical difference between the two groups(P>0.05).The excellent-good rate of screw position in the observation group was higher than that in the control group(P<0.05).The 13 patients were lost to follow-up and 193 patients were followed-up for 6~24 months.Until the last follow-up,the internal fixation was removed in 104 patients,and the internal fixation of other 89 patients were not removed.In the control group,2 patients with poor screw position presented symptoms of nerve root irritation(radicular pain,numbness,weakness,etc)and poor recovery of lower limb motor function,there were no screw fracture and falls off in the the observation group and control group.Conclusions The accuracy of vision FD vario 3D is higher than ordinary C-arm X-ray machine in spinal pedicle screws fixation.

关 键 词：椎弓根螺钉置入 三维平板透视 术中定位 

分 类 号：R687.3[医药卫生—骨科学] R816.8[医药卫生—外科学]