术中计算机断层扫描和C臂透视辅助颈椎后路置钉的准确性  

Accuracy of intraoperative computed tomography and C-arm fluoroscopy assisted posterior cervical nailing

作　　者：钱向辉 QIAN Xiang-hui(Department of Radiology,Shijiazhuang Eighth Hospital,Hebei,050000,China)

机构地区：[1]石家庄市第八医院放射科,河北石家庄050000

出　　处：《颈腰痛杂志》2023年第3期410-413,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的比较术中计算机断层扫描(intraoperative computed tomography,iCT)和C臂透视辅助颈椎后路置钉的准确性。方法选择2019年1月~2021年12月在本院接受颈椎后路固定术治疗的93例患者作为研究对象,根据治疗方法将患者分为研究组(n=44)和对照组(n=49)。研究组采用iCT导航下螺钉置入;对照组在C臂透视引导下,参照椎管内和椎管外解剖标志完成螺钉置入定位。观察两组患者螺钉置入准确率。结果研究组螺钉置入准确率高于对照组,差异有统计学意义(P<0.05)。研究组C_(1)~C_(2)螺钉置入准确率高于对照组,差异有统计学意义(P<0.05);研究组下颈椎螺钉置入准确率均高于对照组,差异均有统计学意义(P<0.05)。研究组侧块螺钉和椎弓根螺钉置入准确率均高于对照组,差异均有统计学意义(P<0.05)。结论iCT导航辅助置入颈椎椎弓根钉和侧块螺钉的准确性明显优于C臂透视辅助置钉。Objective To compare the accuracy of intraoperative computed tomography(iCT)and C-arm fluoroscopy assisted posterior cervical nailing.Methods A total of 93 patients who underwent posterior cervical fixation in our hospital from January 2019 to December 2021 were selected as the research objects.According to the treatment methods,the patients were divided into study group(n=44)and control group(n=49).The former was treated with screw placement under the guidance of ICT,and the latter with intraspinal and extraspinal anatomical markers under the guidance of C-arm fluoroscopy.The accuracy of screw placement in the two groups was observed.Results The accuracy of screw placement in the study group was significantly higher than that in the control group(P<0.05).The accuracy of C _(1)~C _(2) screw placement in the study group was higher than that in the control group(P<0.05),and the accuracy of lower cervical screw placement in the study group was higher than that in the control group(P<0.05).The accuracy of lateral mass screw and pedicle screw placement in the study group was higher than that in the control group(P<0.05).Conclusion The accuracy of iCT navigation assisted placement of cervical pedicle screws and lateral mass screws is significantly better than that of c-arm fluoroscopy assisted placement of screws.

关 键 词：颈椎手术 螺钉置入 椎弓根螺钉 侧块螺钉 术中CT导航 

分 类 号：R445.4[医药卫生—影像医学与核医学] R687.3[医药卫生—诊断学]