椎弓根螺钉个体化置钉设计在青少年特发性脊柱侧凸中的应用  

Application of individualized pedicle screw placement design in adolescent idiopathic scoliosis

作　　者：罗敏[1,2] 刘洋贝 杨曦 冯敬[2] 范斌[2] 刘立岷[1] LUO Min;LIU Yang-bei;YANG Xi;FENG Jing;FAN Bin;LIU Li-min(Dept of Orthopaedics,West China Hospital of Sichuan University,Chengdu,Sichuan 610041, China;Dept of Spine Surgery, the Third People′s Hospital of Mianyang City, Mianyang,Sichuan 621000, China)

机构地区：[1]四川大学华西医院骨科,四川成都610041 [2]绵阳市第三人民医院脊柱外科,四川绵阳621000

出　　处：《临床骨科杂志》2020年第5期609-613,共5页Journal of Clinical Orthopaedics

基　　金：四川省科技厅重点研发项目(编号:2017SZ0046)。

摘　　要：目的探讨术前椎弓根螺钉个体化置钉设计在青少年特发性脊柱侧凸(AIS)中的应用效果。方法将35例AIS患者根据术前是否进行个体化椎弓根螺钉置钉设计分为观察组(进行个体化椎弓根螺钉置钉设计,19例)和对照组(未进行个体化椎弓根螺钉置钉设计,16例)。比较两组置钉准确率、手术时间、术中出血量、侧凸矫正率及并发症。结果观察组共置钉228枚,不良置钉8枚,高危置钉2枚,置钉准确率95.6%;侧凸矫正率81.5%~95.0%(87.1%±4.6%);术后并发症1例。对照组共置钉216枚,不良置钉15枚,高危置钉5枚,置钉准确率90.7%;侧凸矫正率80.0%~94.3%(88.0%±3.7%);术后并发症2例。观察组置钉准确率高于对照组,手术时间、术中出血量短(少)于对照组,差异均有统计学意义(P<0.05)。术后并发症、侧凸矫正率两组比较差异均无统计学意义(P>0.05)。结论采用椎弓根螺钉个体化置钉设计能够提高AIS术中椎弓根螺钉的置钉准确率、缩短手术时间、减少术中出血量。Objective To investigate the application effect of preoperative pedicle screw individualized screw placement design in adolescent idiopathic scoliosis(AIS).Methods The 35 AIS patients were divided into observation group(individualized pedicle screw setting design,19 cases)and control group(no individualized pedicle screw setting design,16 cases)according to whether individualized pedicle screw setting design was carried out before surgery.The accuracy of screw placement,operation time,intraoperative blood loss,scoliosis correction rate and complications were compared between the two groups.Results Observation group had a total of 228 screwing,8 defective screwing,2 high-risk screwing,with an accuracy rate of 95.6%.The scoliosis correction rate was 81.5%~95.0%(87.1%±4.6%).There was 1 case of postoperative complication.Control group had a total of 216 screwing,15 defective screwing,5 high-risk screwing,with an accuracy rate of 90.7%,The scoliosis correction rate was 80.0%~94.3%(88.0%±3.7%).There were 2 cases of postoperative complications.The accuracy of screw placement in the observation group was higher than that in the control group,and the operation time and intraperative blood loss were shorter(less)than those in the control group,with statistically significant differences(P<0.05).There were no significant differences in postoperative complications and scoliosis correction rate between the two groups(P>0.05).Conclusions Individualized pedicle screw placement design can improve the accuracy of pedicle screw placement in AIS surgery,shorten the operation time,reduce intraoperative blood loss.

关 键 词：置钉设计 椎弓根螺钉 脊柱侧凸 置钉准确率 

分 类 号：R682.3[医药卫生—骨科学] R687.3[医药卫生—外科学]