摘要
目的：通过术前对腰5（L5）椎体骨折预定采用腰椎椎弓根螺钉内固定术患者CT影像资料的三维重建,达到提高手术导航系统引导下腰椎椎弓根螺钉内固定术入路准确性和可靠性的目的。方法回顾性对照分析皖南医学院弋矶山医院脊柱骨科2015年3月至2015年8月共20例（男13人,女7人,平均年龄52.85岁,年龄范围32~68岁）,其中A组10例接受导航系统引导下术前有CT三维重建的L5椎体椎弓根螺钉内固定术的病例和B组10例接受导航系统引导下术前仅有C臂机辅助定位的L5椎体椎弓根螺钉内固定术的病例,分析A、 B两组在不同定位方式下腰椎椎弓根螺钉置入的矢状面角（ sagital section angle, SSA）、水平面角（ transverse section angle, TSA）、进针深度的差异。结果 A、 B两组共20例手术均顺利完成,无手术或围手术期死亡病例,术后随访3个月。 A、 B两组术后SSA、 TSA、进针深度的比较, P〈0.05,差异有统计学意义。结论术前有CT三维重建的A组在SSA、 TSA、进针深度上明显优于术前仅有C臂机辅助定位的B组,说明术前CT三维重建在提高导航系统引导下腰椎椎弓根螺钉内固定术入路准确性和可靠性上有重要价值。
Objective To improve the accuracy and reliability of the pedicle screw fixation under the guidance of the surgery navi-gation system by using the preoperative CT three dimensional reconstruction image data of the patients in the lumbar veterbrae 5 pedicle screw internal fixation. Methods A retrospective case-control study：20 cases in Department of Orthopaedics, The First Affiliated Hospital of Wannan Medical College from March, 2015 to August, 2015 （13 males, 7 females, average age 52. 85 years old, ages random from 32 to 68 ） . 10 cases in group A accepted lumbar veterbrae 5 pedicle screw fixation with the help of navigation system guided by three dimensional reconstruction of CT images before surgery and 10 cases in group B accepted lumbar veterbrae 5 pedicle screw internal fixation with the help of navigation system only guided by a C arm X-ray before surgery, and the sagital section angle （ SSA） , the transverse section angle （ TSA） and the difference of needle depth between the two groups were analyzed. Results 20 cases in both groups were operated successfully, with no operative and perioperative death, and then there was a follow-up for 3 months. There was statistically significant difference by comparing SSA, TSA and the needle depth between the two groups, P〈0. 05. Conclusion Group A with CT three dimensional reconstruction before surgery is significantly better than group B which is only guided by C arm X-ray before surgery in TSA , SSA and the needle depth, which shows that preoperative CT three dimensional reconstruction un-der the guidance of navigation system plays an important role in improving the accuracy and reliability of lumbar pedicle screw fixation.
出处
《辽宁医学院学报》
CAS
2016年第3期79-82,共4页
Journal of Liaoning Medical University (LNMU) Bimonthly
关键词
CT三维重建
腰椎
椎弓根螺钉
内固定
CT three dimensional reconstruction
lumbar vertebrae
pedicle screw
internal fixation
