O型臂导航辅助下寰椎与枢椎逆向椎弓根螺钉置入技术的应用疗效及准确性研究  

Efficacy and accuracy of anterior pedicle screw placed assisted by O-arm navigation

作　　者：莫少东 陈源权 艾福志 MO Shaodong;CHEN Yuanquan;AI Fuzhi(Department of Orthopaedics,Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Guangzhou 510120;Department of Orthopaedics,Eighth Affiliated Hospital of Sun Yat-sen University,Shenzhen 518033,Guangdong,China)

机构地区：[1]中山大学孙逸仙纪念医院骨外科,广州510120 [2]中山大学附属第八医院骨科,广东深圳518033

出　　处：《中华骨与关节外科杂志》2024年第1期31-37,共7页Chinese Journal of Bone and Joint Surgery

基　　金：广州市科技计划项目(2015A030312004)。

摘　　要：目的:分析O型臂导航辅助下寰椎与枢椎逆向椎弓根螺钉置入技术的应用疗效及准确性。方法:回顾性分析2020年1月至2022年12月收治的20例行经口寰枢椎复位植骨融合内固定术的寰枢椎脱位患者的相关资料。按照不同的置钉方式,20例患者分为导航辅助组及徒手置钉组,记录两组手术时间、术中出血量,术前及术后的斜坡椎管角(CCA)及延髓脊髓角(CMA),对比分析两种置钉方式的应用疗效,采用改良Park的标准对逆向椎弓根钉置入的准确性进行评估比较。结果:两组患者的手术时间、术中出血量、术前术后CCA及CMA比较,差异均无统计学意义(P均>0.05)。两组患者术后CCA及CMA均较术前明显改善,差异有统计学意义(P<0.05),导航辅助组置钉准确性优于徒手置钉组(P<0.05)。结论:通过O型臂导航技术辅助进行经口寰枢椎逆向椎弓根螺钉的置入可获得与徒手置钉相当的治疗疗效,同时提高螺钉置入的准确性,降低置钉相关并发症的风险。Objective:To investigate the efficacy and accuracy of the anterior pedicle screw placed assisted by O-arm navigation.Methods:From January 2020 to December 2021,20 patients with atlantoaxial dislocation who underwent transoral atlantoaxial reduction plate were retrospectively analyzed.They were divided into a navigation group and a freehand group acording to the screw placement methods.The operation time,intraopeative blood loss,preoperative and postoperative clivus-canal angle(CCA)and cervico-medullary angle(CMA)were recorded for the evaluation of clinical efficacy.The accuracy of pedicle screw placement was evaluated according to the postoperative cervical CT and improved screw grading criteria proposed by modified Park standard.Results:There was no significant difference in the operation time,intraopeative blood loss,preoperative or postoperative CCA or CMA between the two groups(P>0.05).Postoperative CCA and CMA were significantly larger than preoperative ones in both groups(P<0.05).The accuracy of screw placement in the navigation group was significantly higher than that in the freehand group(P<0.05).Conclusions:Anterior pedicle screw placement assisted by O-arm navigation can achieve the same clinical efficacy with the freehand screw placement.Meanwhile,it can improve the accuracy and safety of screw placement and reduce postoperative complications.

关 键 词：O型臂导航 寰枢椎脱位 椎弓根螺钉 准确性 

分 类 号：R687.3[医药卫生—骨科学]