术前椎弓根平面CT在腰椎椎弓根置钉中的应用研究
详细信息 查看官网全文
- 英文论文题名：The application of preoperative pedicle plane CT in lumbar pedicle screw fixation
- 论文作者：刘政 ; 李宏伟 ; 王海洲 ; 水岩 ; 于卓力 ; 王帅 ; 纪楠
- 英文论文作者：LIU Zheng ; LI Hong-wei ; WANG Hai-zhou ; Shui Yan ; YU Zhuo-li ; Wang Shuai ; Ji Nan ; Department of Orthopaedic Surgery ; the 202 Hospital of PLA
- 年：2017
- 作者机构：中国人民解放军第202医院骨科;
- 论文关键词：腰椎 ; 椎弓根螺钉 ; 椎弓根CT ; 骨螺丝 ; 应用研究
- 英文论文关键词：Lumbar spine ; Pedicle screws ; Pedicle-plane CT ; Bone screws ; Application
- 会议召开时间：2017-08-31
- 会议录名称：第十四届沈阳科学学术年会论文集（理工农医）
- 语种：中文
- 分类号：R687.3
- 学会代码：SYKJ
- 会议名称：第十四届沈阳科学学术年会
- 会议地点：中国辽宁沈阳
- 主办单位：中共沈阳市委、沈阳市人民政府
- 学会名称：沈阳市科学技术协会
- 页数：7
- 文件大小：393k
- 原文格式：D
- 会议级别：地方
摘要
目的:探讨腰椎手术前椎弓根平面CT扫描在椎弓根螺钉内固定术中的应用价值。方法:在实验组45例患者的腰椎椎弓根平面进行CT图像扫描,图像传输至PACS医生诊断工作站,应用影像学技术术前确定最佳置钉点及置钉通道,观察椎弓根形态结构,测量预置入的椎弓根螺钉长度、预置入椎体的椎弓根最狭窄处宽度等相关参数,进行个体化置钉,与未行置钉椎体椎弓根平面CT扫描的对照组进行比较。结果:两组患者在手术时间、术中出血量、术中透视次数等多方面比较,均存在明显差异。结论:椎弓根平面CT不仅能帮助术者了解椎弓根的形态结构,更能提供某一特定椎弓根的个体化、量化的进钉点及进钉角度、螺钉长度等多方面数据,从而能够降低螺钉误置率,减少手术相关并发症,是一种简便、可靠而且廉价的方法。
Objective: To evaluate the value of pedicle-plane CT in the preoperative planning of pedicle screw fixation for lumbar spine surgery. Methods: Scanning CT image in the experimental group of 45 patients with lumbar pedicle plane, image transmission to PACS doctor workstation, with the application of imaging technology to determine the optimal position of screw and anterior screw channel, pedicle morphology observation, measurement of pedicle screw into the preset length, pre implantation of pedicle vertebral stenosis most parameters such as width, for individual screw, and no screw group vertebral pedicle plane CT scanning were compared. Results: Two groups of patients in the operation time, intraoperative blood loss, intraoperative fluoroscopy and other aspects of the comparison, there are significant differences. Conclusions: Preoperative pedicle plane CT scan can not only help the patients to understand the morphological structure of the pedicle, can provide a specific individual, quantification of the pedicle screw entry point and angle of screw, screw length and other aspects of the data, which can reduce the screw misplacement rate, reduce surgical complications, is a simple, reliable and cheap method.
Objective: To evaluate the value of pedicle-plane CT in the preoperative planning of pedicle screw fixation for lumbar spine surgery. Methods: Scanning CT image in the experimental group of 45 patients with lumbar pedicle plane, image transmission to PACS doctor workstation, with the application of imaging technology to determine the optimal position of screw and anterior screw channel, pedicle morphology observation, measurement of pedicle screw into the preset length, pre implantation of pedicle vertebral stenosis most parameters such as width, for individual screw, and no screw group vertebral pedicle plane CT scanning were compared. Results: Two groups of patients in the operation time, intraoperative blood loss, intraoperative fluoroscopy and other aspects of the comparison, there are significant differences. Conclusions: Preoperative pedicle plane CT scan can not only help the patients to understand the morphological structure of the pedicle, can provide a specific individual, quantification of the pedicle screw entry point and angle of screw, screw length and other aspects of the data, which can reduce the screw misplacement rate, reduce surgical complications, is a simple, reliable and cheap method.
引文
[1]Sarlak AY,Tosun B,Atmaca H,et al.Evaluation of thoracic pedicle screw placement in adolescent idiopathic scoliosis.Eur Spine J.2009;18(12):1892-1897.
[2]Hicks JM,Singla A,Shen FH,et a1.Complications of pedicle screw fixation in scoliosis surgery:a systematic review.Spine(Phila Pa 1976),2010,35(11):E465-E470.
[3]Park J H,Jeon SR,Roh SWet al.The safety and accuracy of freehand pedicle screw placement in the subaxial cervical spine:a series of 45 consecutive patients[J].Spine,2014,39(4):280-285.
[4]Parker S L,Mc Girt M J,Farber S H,et al.Accuracy of free-hand pedicle screws in the thoracic and lumbar spine:analysis of 6816 consecutive screws[J].Neurosurgery,2011,68(1):170-178.
[5]Karapinar L,Erel N,Ozturk H,et al.Pedicle screw placement with a free hand technique in thoracolumbar spine:is it safe?J Spinal Disord Tech,2008,21(1):63-67.
[6]Larson AN,Polly DW,Jr,Guidera KJ,et al.The accuracy of navigation and 3D image-guided placement for the placement of pedicle screws in congenital spine deformity[J].J Pediatr Orthop,2012,6:23-29.
[7]黄彦,吕浩然,杨进顺,等.术中三维导航引导下脊柱侧凸的椎弓根螺钉置入研究[J].中国矫形外科杂志,2012,24:2228-2231.Huang Yan,Lv Haoran,Yang Jinshun,et al.Study of pedicle screw placement in scoliosis guided by intraoperative three-dimensional navigation[J].Chinese Journal of Orthopaedic Surgery,2012,24:2228-2231
[8]Ughwanogho E,Patel NM.Computed tomography-guided navigation of thoracic pedicle screws for adolescent idiopathic scoliosis results in more accurate placement and less screw removal[J].Spine,2012,8:473-478.
[9]Wang S,Zhang J,Qiu G,et al.Posterior hemivertebra resection with bisegmental fusion for congenital scoliosis:more than 3 year outcomes and analysis of unanticipated surgeries.Eur Spine J.2013;22(2):387-393.
[10]Tian NF,Huang QS,Zhou P,et al.Pedicle screw insertion accurary with different assisted methods:a systematic review andmeta-analysis of comparative studies.Eur Spin J,2010,20(6):846-859.
[11]Verma R,Krishan S,Haendl mayer K,et al.Functional outcome of computer-assisted spinal pedicle screw placement:a syetematic review and meta-analysis of 23 studies including 5,992 pedicle screws,Eur Spine J.2010,19(3):370-375.
[12]张少杰,王星,等.个性化导航模板辅助儿童颈椎椎弓根螺钉置入与徒手置入准确性的对比研究[J].中国脊柱脊髓杂志,2014,24(11):1020-1024.Zhang Shaojie,Wang Xing,et al.A comparative study of the accuracy of personalized navigation template in the treatment of children with cervical pedicle screw placement and manual implantation[J].Chinese Journal of spine and spinal cord,2014,24(11):1020-1024.
[13]Rajasekaran S,Vidyadhara S,Ramesh P,et al.Randomized clinical study to compare the accuracy of navigated and non-navigated thoracic pedicle screws in deformity correction surgeries.Spine 2007,32:E56-64.
[14]Tian NF,Xu HZ.Image-guided pedicle screw insertion accuracy:a meta-analysis.Int Orthop,2009,33(4):895-903.
[15]Silbermann J,Riese F,Allam Y,et al.Computer tomography assessment of pedicle screw placement in lumbar and sacral spine:comparison between free-hand and O-arm based navigation techniques.Eur Spine J,2011,20(6):875-881.
[16]Kosmopoulos V,Schizas C.Pedicle screw placement accruracy:a meta-analysis.Spine(Phila Pa1976),2007,32(3):E111-120.
[17]高小亮,黄卫民,胡永胜,等.汉族与维吾尔族青年男性L4、L5椎弓根CT形态差异对植入物内固定的影响.中国组织工程研究,2012,16:1581.Gao Xiaoliang,Huang Weimin,et al.Effects of L4 and L5 pedicle CT morphological differences on the internal fixation of young Chinese and Uygur male.Chinese tissue engineering research,2012,16:1581.
[18]张俊玮,王展波,汪睿,等.新疆维吾尔族与汉族成人椎弓根解剖差异的CT研究[J].临床放射学杂志,2014,33(4):570-573.Zhang Junwei,Wang Zhanbo,Wang Rui,et al.CT study on the anatomical differences of the pedicle of vertebral arch between Uygur and Han Adults in Xinjiang[J].Journal of Clinical Radiology,2014,33(4):570-573.
[19]马岩,李岩,马威,等.中国北方地区成人椎弓根形态的测量及临床意义[J].中国临床解剖学杂志,2009,27(3):295-298.Ma Yan,Li Yan,Ma Wei,et al.Measurement and clinical significance of pedicle morphology of adult in North China[J].Chinese Journal of clinical anatomy,2009,27(3)295-298
[20]Panjabi MM,O’Holleran JD,Crisco JJ 3rd,et al.Complexity of the thoracic spine pedicle anatomy.Eur Spine J,1997,6:19-24.
[21]Kurtz SM,Lanman TH,Higgs G,et al.Retrieval analysis of PEEK rods for posterior fusion and motion preservation.Eur Spine J.2013;22(12):2752-2759
[2]Hicks JM,Singla A,Shen FH,et a1.Complications of pedicle screw fixation in scoliosis surgery:a systematic review.Spine(Phila Pa 1976),2010,35(11):E465-E470.
[3]Park J H,Jeon SR,Roh SWet al.The safety and accuracy of freehand pedicle screw placement in the subaxial cervical spine:a series of 45 consecutive patients[J].Spine,2014,39(4):280-285.
[4]Parker S L,Mc Girt M J,Farber S H,et al.Accuracy of free-hand pedicle screws in the thoracic and lumbar spine:analysis of 6816 consecutive screws[J].Neurosurgery,2011,68(1):170-178.
[5]Karapinar L,Erel N,Ozturk H,et al.Pedicle screw placement with a free hand technique in thoracolumbar spine:is it safe?J Spinal Disord Tech,2008,21(1):63-67.
[6]Larson AN,Polly DW,Jr,Guidera KJ,et al.The accuracy of navigation and 3D image-guided placement for the placement of pedicle screws in congenital spine deformity[J].J Pediatr Orthop,2012,6:23-29.
[7]黄彦,吕浩然,杨进顺,等.术中三维导航引导下脊柱侧凸的椎弓根螺钉置入研究[J].中国矫形外科杂志,2012,24:2228-2231.Huang Yan,Lv Haoran,Yang Jinshun,et al.Study of pedicle screw placement in scoliosis guided by intraoperative three-dimensional navigation[J].Chinese Journal of Orthopaedic Surgery,2012,24:2228-2231
[8]Ughwanogho E,Patel NM.Computed tomography-guided navigation of thoracic pedicle screws for adolescent idiopathic scoliosis results in more accurate placement and less screw removal[J].Spine,2012,8:473-478.
[9]Wang S,Zhang J,Qiu G,et al.Posterior hemivertebra resection with bisegmental fusion for congenital scoliosis:more than 3 year outcomes and analysis of unanticipated surgeries.Eur Spine J.2013;22(2):387-393.
[10]Tian NF,Huang QS,Zhou P,et al.Pedicle screw insertion accurary with different assisted methods:a systematic review andmeta-analysis of comparative studies.Eur Spin J,2010,20(6):846-859.
[11]Verma R,Krishan S,Haendl mayer K,et al.Functional outcome of computer-assisted spinal pedicle screw placement:a syetematic review and meta-analysis of 23 studies including 5,992 pedicle screws,Eur Spine J.2010,19(3):370-375.
[12]张少杰,王星,等.个性化导航模板辅助儿童颈椎椎弓根螺钉置入与徒手置入准确性的对比研究[J].中国脊柱脊髓杂志,2014,24(11):1020-1024.Zhang Shaojie,Wang Xing,et al.A comparative study of the accuracy of personalized navigation template in the treatment of children with cervical pedicle screw placement and manual implantation[J].Chinese Journal of spine and spinal cord,2014,24(11):1020-1024.
[13]Rajasekaran S,Vidyadhara S,Ramesh P,et al.Randomized clinical study to compare the accuracy of navigated and non-navigated thoracic pedicle screws in deformity correction surgeries.Spine 2007,32:E56-64.
[14]Tian NF,Xu HZ.Image-guided pedicle screw insertion accuracy:a meta-analysis.Int Orthop,2009,33(4):895-903.
[15]Silbermann J,Riese F,Allam Y,et al.Computer tomography assessment of pedicle screw placement in lumbar and sacral spine:comparison between free-hand and O-arm based navigation techniques.Eur Spine J,2011,20(6):875-881.
[16]Kosmopoulos V,Schizas C.Pedicle screw placement accruracy:a meta-analysis.Spine(Phila Pa1976),2007,32(3):E111-120.
[17]高小亮,黄卫民,胡永胜,等.汉族与维吾尔族青年男性L4、L5椎弓根CT形态差异对植入物内固定的影响.中国组织工程研究,2012,16:1581.Gao Xiaoliang,Huang Weimin,et al.Effects of L4 and L5 pedicle CT morphological differences on the internal fixation of young Chinese and Uygur male.Chinese tissue engineering research,2012,16:1581.
[18]张俊玮,王展波,汪睿,等.新疆维吾尔族与汉族成人椎弓根解剖差异的CT研究[J].临床放射学杂志,2014,33(4):570-573.Zhang Junwei,Wang Zhanbo,Wang Rui,et al.CT study on the anatomical differences of the pedicle of vertebral arch between Uygur and Han Adults in Xinjiang[J].Journal of Clinical Radiology,2014,33(4):570-573.
[19]马岩,李岩,马威,等.中国北方地区成人椎弓根形态的测量及临床意义[J].中国临床解剖学杂志,2009,27(3):295-298.Ma Yan,Li Yan,Ma Wei,et al.Measurement and clinical significance of pedicle morphology of adult in North China[J].Chinese Journal of clinical anatomy,2009,27(3)295-298
[20]Panjabi MM,O’Holleran JD,Crisco JJ 3rd,et al.Complexity of the thoracic spine pedicle anatomy.Eur Spine J,1997,6:19-24.
[21]Kurtz SM,Lanman TH,Higgs G,et al.Retrieval analysis of PEEK rods for posterior fusion and motion preservation.Eur Spine J.2013;22(12):2752-2759
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |