不同年资医师在O臂机导航系统辅助下置入椎弓根螺钉的准确性比较  

Comparison of the accuracy of pedicle screw placement assisted by O-arm navigation system by different seniority doctors

作　　者：李玉伟[1] 李修智 崔巍[1] 周鹏[1] 李程 效伟 李凡 LI Yu-wei;LI Xiu-zhi;CUI Wei;ZHOU Peng;LI Cheng;XIAO Wei;LI Fan(Dept of Spine Surgery,the Central Hospital of Luohe City,Luohe,Henan 462000,China)

机构地区：[1]漯河市中心医院脊柱科,河南漯河462000 [2]郑州大学医学院临床医学系,河南郑州450052

出　　处：《临床骨科杂志》2023年第5期629-633,共5页Journal of Clinical Orthopaedics

基　　金：河南省教育厅高等学校重点科研项目(编号:22B320004)。

摘　　要：目的探讨不同年资医师在O臂机导航S8系统辅助下置入椎弓根螺钉的准确性。方法根据是否应用O臂机导航S8系统辅助和置钉医师年资不同将行腰椎后路椎间融合术治疗的98例患者分为A组(低年资医师使用O臂机导航S8系统辅助置钉,25例)、B组(高年资医师使用O臂机导航S8系统辅助置钉,24例)、C组(低年资医师使用C臂机辅助置钉,23例)、D组(高年资医师使用C臂机辅助置钉,26例)。记录置钉数量、置钉时间、一次性置钉成功率及置钉准确性评分。结果患者均获得随访,时间6~22(11.7±9.3)个月。共置入腰椎椎弓根螺钉392枚,其中A组100枚,B组96枚,C组92枚,D组104枚。置钉时间C组均长于A、B、D组(P<0.05),A、B、D组比较差异均无统计学意义(P>0.05)。一次性置钉成功率、置钉准确性评分C组均低于A、B、D组(P<0.05),A、B、D组比较差异均无统计学意义(P>0.05)。结论腰椎后路椎间融合术中,应用O臂机导航S8系统可以显著提高低年资医师的置钉准确性、一次性置钉成功率,缩短置钉时间。但对于高年资医师,使用O臂机导航S8系统和C臂机辅助置钉的置钉准确性相当。Objective To investigate the accuracy of pedicle screw placement assisted by O-arm navigation S8 system by different seniority doctors.Methods According to whether using the O-arm navigation S8 system and the different seniority of the screwing surgeon,98 patients who were performed with posterior lumbar interbody fusion(PLIF)treatment were divided into group A(junior surgeons used the O-arm navigation S8 system to assist screwing,25 cases)and group B(senior surgeons used the O-arm navigation S8 system to assist screwing,24 cases),group C(junior surgeons used C-arm machine to assist screwing,23 cases),Group D(senior surgeons used C-arm machine to assist screwing,26 cases).The screwing number,screwing time,success rate of disposable screwing and accuracy of screwing were recorded.Results All patients were followed up for 6~22(11.7±9.3)months.A total of 392 pedicle screws were inserted,including 100 screws of group A,96 screws of group B,92 screws of group C,and 104 screws of group D.The screw placement time:group C was longer than group A,B and D(P<0.05),and there was no statistical significance in group A,B and D(P>0.05).The success rate and accuracy score of disposable screw placement:group C were lower than those in group A,B and D(P<0.05),and there was no statistical significance in group A,B and D(P>0.05).Conclusions In PLIF internal fixation process,the application of O-arm navigation S8 system can significantly improve the accuracy of screw placement,disposable success rate of screw placement,and shorten the time of screw placement by junior surgeons.However,for senior surgeons,the accuracy of screw placement of O-arm machine navigation S8 systemis is comparable to that of C-arm machine assisted screwing.

关 键 词：腰椎 椎弓根螺钉 O臂机导航系统 腰椎后路椎间融合术 

分 类 号：R681.5[医药卫生—骨科学] R687.32[医药卫生—外科学] R319[医药卫生—临床医学]