摘要
[目的]探讨导航辅助置入下颈椎椎弓根螺钉的准确性和产生误差的原因。[方法]25例下颈椎疾患手术病人,导航辅助下置入144枚颈椎(C3～7)椎弓根螺钉,术后行X线、CT检查,横断位测量螺钉中线与椎弓根内壁的相对位置、与椎体中线的角度;矢状位测量螺钉中线与椎弓根上壁的相对位置、与椎体上缘的角度;并与导航图像的对应数据进行统计学分析。[结果]2枚螺钉穿出椎弓根上壁,3枚螺钉穿出椎弓根外壁入椎动脉孔,其它螺钉术后CT和术中导航图像所显示的位置角度无显著性差异,导航图像的显示是基于坚硬物体原则,颈椎手术本身特点不可能完全满足如此要求,两者偏差表现为"漂移"现象。[结论]导航辅助置入下颈椎椎弓根螺钉准确性显著提高,术中漂移是置钉偏差的原因。
[ Objective] To evaluate the accuracy of computer-assisted cervical pedicle screw installation and discuss the reasons of screw malposition. [ Method] Totally 144 cervical pedicle screws were installed by computer-assisted navigation in 25 patients with lower cervical spinal disease. All the patients were examined by X-rays and CT after operation. Screw position and direction were measured on the sagittal and transsection image of intraoperative navigation and post-operative CT. The result was analyzed statistically. [ Result] Two screws perforated the upper pedicle wall ,3 deviated from the lateral pedicle wall. There was no statistical difference in screw position or direction between navigation and CT image. Navigational images were based on the principle of rigid tissue. [ Conclusion] Computer-assisted navigation can improve the accuracy of cervical pedicle screw installation. Screw malposition is responsible for the excursion phenomenon.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2009年第4期260-263,共4页
Orthopedic Journal of China
关键词
计算机辅助导航
颈椎
椎弓根螺钉
computer-assisted navigation
cervical spine
pediele screw
