腰骶骨椎弓根螺钉置入内固定：CT三维重建虚拟导航的辅助

腰骶骨椎弓根螺钉置入内固定：CT三维重建虚拟导航的辅助陈晓明;陈前芬;肖增明;宗少晖
【期刊名称】《中国组织工程研究》
【年(卷),期】2015(000)009
【摘要】背景：椎弓根螺钉内固定系统广泛应用于创伤、畸形、肿瘤、退行性变等各种各种腰骶部疾患的治疗，如何提高置钉准确性一直是业界关注的热点。

CT 三维重建虚拟导航可以让术者在可视化三维解剖信息的实时引导下进行置钉，使得置钉过程更准确安全。

n<br> 目的：探讨术前CT三维重建虚拟导航技术在腰骶骨椎弓根螺钉内固定中的临床应用价值。

n<br> 方法：选取广西医科大学第一附属医院脊柱骨病外科从2008年7月至2014年11月收治的腰椎骨折、腰椎滑脱及腰椎管狭窄症患者共203例，在术前CT三维重建虚拟导航引导下行腰骶骨椎弓根螺钉内固定，内固定后复查X射线和腰椎三维CT，以Andrew椎弓根螺钉CT位置分级标准进行评估。

n<br> 结果与结论：共置入腰骶椎椎弓根螺钉1088枚，其中1068枚螺钉位置为Ⅰ级,置钉准确率达98.2%。

152例获得随访，随访时间12个月，无内固定物移位、断裂等并发症。

术前CT三维重建虚拟导航技术能为腰骶骨椎弓根螺钉内固定提供三维立体的解剖信息，制定最优置钉计划，使置钉更加精确安全，从而提高整体的修复质量。

%BACKGROUND:Pedicle screw fixation techniques have been widely used in the treatment of lumbar and sacral disease, such as trauma, deformity, tumor and degeneration. How to improve the accuracy of screw placement is a hot topic. CT-based three-dimensional reconstruction navigation technique provides real-time, multi-perspective, three-dimensional visualization of
lumbar and sacral anatomy, and surgeons can perform the pedicle screw insertion procedures confidently with increase of accuracy and safety. n<br> OBJECTIVE:To study the clinical value of CT-based three-dimensional reconstruction navigation technique in the application of lumbar and sacral pedicle screw placement. n<br> METHODS:A total of 203 patients with lumbar and sacral diseases, including lumbar fracture, lumbar spondylolysis and lumbar spinal stenosis, were recruited from Department of Spine&Osteopathy, the First Affiliated Hospital of Guangxi Medical University between July 2008 and November 2014. Patients received pedicle screw placement in lumbar and sacral bone under the guidance of CT-based three-dimensional reconstruction navigation. Postoperative X-
ray films and three-dimensional CT scan of lumbar bone were
routinely&nbsp;examined in each patient. The accuracy of pedicle screw insertion was evaluated with postoperative CT scan according to Andrew classification. n<br> RESULTS AND CONCLUSION:A total of 1 088 screws were inserted in the lumbar and sacral bone. The accuracy of pedicle screw insertion was rated as grade I in 1 068 screws (98.2%) according to postoperative CT scan. 152 cases were fol owed up for average 12 months without any complications, such as internal fixator displacement and rupture. Preoperative CT-based three-dimensional reconstruction navigation technique provides three-dimensional anatomical information, assists to develop pedicle screw insertion plan, enhances the accuracy and further improves the safety of pedicle screw insertion.
【总页数】5页(P1447-1451)
【作者】陈晓明;陈前芬;肖增明;宗少晖
【作者单位】广西医科大学第一附属医院脊柱骨病外科，广西壮族自治区南宁市530021;广西医科大学第一附属医院脊柱骨病外科，广西壮族自治区南宁市530021;广西医科大学第一附属医院脊柱骨病外科，广西壮族自治区南宁市530021;广西医科大学第一附属医院脊柱骨病外科，广西壮族自治区南宁市530021
【正文语种】中文
【中图分类】R318
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