O臂导航辅助脊柱后路减压植骨融合内固定治疗脊柱退行性疾病的临床研究  

O-arm navigation-assisted spinal decompression and bone grafting via a posterior approach combined with internal fixation in the treatment of spinal degenerative diseases

作　　者：孙敬争 贾学勤 张东芝 李丹丹 张丽 段伟利 SUN Jing-zheng;JIA Xue-qin;ZHANG Dong-zhi;LI Dan-dan;ZHANG Li;DUAN Wei-li

机构地区：[1]南阳市中医院骨科,河南南阳473000 [2]南阳市中医院脊柱中心,河南南阳473000 [3]南阳市中医院手术室,河南南阳473000

出　　处：《中国疗养医学》2024年第12期93-96,共4页Chinese Journal of Convalescent Medicine

基　　金：南阳市中医院独山院区(南阳市骨科医院)2023年科研“苗圃计划”(2023005)。

摘　　要：目的探讨O臂导航辅助脊柱后路减压植骨融合内固定治疗脊柱退行性疾病的临床效果。方法选取2022年12月至2023年5月在南阳市中医院独山院区行脊柱退行性疾病手术患者106例,按随机数字表分为O臂组与C臂组,各53例。O臂组行O臂导航技术下脊柱后路减压植骨融合内固定术治疗,C臂组行C臂导航技术下脊柱后路减压植骨融合内固定术治疗。对比两组围术期指标、腰椎功能、腰腿疼痛及并发症。结果O臂组住院时间为(7.23±1.78)d、手术时间(196.21±36.85)min,短于C臂组(9.62±2.88)d、(260.94±68.42)min,差异有统计学意义(P<0.05);O臂组术中出血量为(76.32±24.15)mL、透视次数为(4.45±1.12)次,少于C臂组(108.21±28.65)mL、(11.58±2.64)次,差异有统计学意义(P<0.05);O臂组手术置钉准确率优于C臂组,差异有统计学意义(P<0.05);两组术前Oswestry功能障碍指数(ODI)评分和腰、腿部视觉模拟评分法(VAS)评分比较,差异无统计学意义(P>0.05);术后3个月两组ODI评分和腰、腿部VAS评分均低于术前,其中O臂组ODI评分为(10.54±2.16)分、腰部VAS评分为(2.06±0.64)分、腿部VAS评分为(1.01±0.35)分,均低于C臂组(12.66±2.31)分、(2.71±0.72)分、(1.33±0.42)分,差异有统计学意义(P<0.05);两组术后并发症总发生率比较,差异无统计学意义(P>0.05)。结论脊柱退行性疾病手术中使用O臂导航技术能够提高手术置钉准确率,缩短手术用时,减少出血量及术中透视次数,减轻腰腿疼痛,改善腰椎功能。Objective To investigate the clinical effect of O-arm navigation-assisted spinal decompression and bone grafting via a posterior approach combined with internal fixation in the treatment of spinal degenerative diseases.Methods From December 2022 to May 2023,totally 106 patients with an elective surgery for spinal degenerative diseases in Dushan Hospital of Nanyang City of Traditional Chinese Medicine were selected and randomly divided into O-arm group and C-arm group according to random number table method,with 53 cases in each group.Patients in the O-arm group and C-arm group were treated with spinal decompression and bone grafting via a posterior approach combined with internal fixation assisted with O-arm and C-arm,respectively.Perioperative indexes,lumbar function,lumbar pain and complications were compared between the two groups.Results The hospitalization time([7.23±1.78]d VS[9.62±2.88]d)and operation time([196.21±36.85]min VS[260.94±68.42]min)of O-arm group were significantly shorter than those of C-arm group(P<0.05).The intraoperative blood loss([76.32±24.15]mL VS[108.21±28.65]mL)and fluoroscopy times([4.45±1.12]times VS[11.58±2.64]times)in the O-arm group were significantly less than those of the C-arm group(P<0.05).The accuracy of nail placement in O-arm group was significantly better than that in C-arm group(P<0.05).There was no significant difference between the preoperative Oswestry disability index(ODI)scores and the visual analogue scale(VAS)scores of the lumbar and legs between the two groups(P>0.05).Three months after surgery,ODI scores and VAS scores of lumbar and legs in both groups were significantly lower than those before surgery,and the ODI scores([10.54±2.16]points VS[12.66±2.31]points)and VAS scores of lumbar([2.06±0.64]points VS[2.71±0.72]points)and legs([1.01±0.35]points VS[1.33±0.42]points)in the O-arm group were significantly lower than those of the C-arm group(P<0.05).There was no significant difference in the total incidence of postoperative complications between the t

关 键 词：脊柱退行性疾病 O臂导航技术 腰椎功能 C臂导航技术 腰腿疼痛 

分 类 号：R687.3[医药卫生—骨科学]