摘要
目的 研制一种新的经皮经椎弓根置钉定位辅助器械,方便准确的辅助经椎弓根置钉手术操作.方法 术前将每个椎体经椎弓根平面行CT扫描,测量每个椎体水平面椎弓根螺钉植入角度（TSA）和矢状面椎弓根螺钉植入角度（SSA）,将其延长线与背部皮肤相交,定位皮肤穿刺点,进行穿刺.两具新鲜冰冻脊柱标本分为定位器组及徒手组,各32个椎弓根进行验证实验.分别在定位器辅助及徒手下穿刺,比较术前与术后的准确率.结果 定位器组穿刺TSA偏差率为（10.83±3.41）%,徒手组穿刺TSA偏差率为（19.08±4.21）%（P＜0.05）;定位器组穿刺SSA偏差率为（13.13±4.37）%,徒手组穿刺SSA偏差率为（21.15±6.78）%（P＜0.05）.经皮胸腰椎弓根置钉三维定位器偏差率小,可有效辅助完成经皮椎弓根手术操作.结论 经皮胸腰椎弓根置钉三维定位器具有体积小、安装灵活、固定牢固、测量角度准确等优点,可应用于标本研究以观察其辅助穿刺的效果,并进一步运用于临床辅助手术.
Objective To develop a novel stereotaxic navigator that may facilitate percutaneous thoracolumbar pedicle screw placement.Methods Before operation,CT scan was used to study every plane that passes through the pedicle of individual vertebrae,on which sagittal and transverse section angles （sagital screw angle,SSA;transverse screw angle,TSA）were delineated.The points on the back where extended lines of SSA,TSA intersect the skin were designated as puncture sites.Two frozen-fresh specimens of the spine each containing 32 pedicles,were assigned as the navigator group and freehand group,for the confirmatory test.Accuracy of the screw placement was compared between the two groups.Results The aberrance rate was（10.83±3.41）%with navigator vs（19.08±4.21）%with freehand via TSA（P〈0.05）,and （13.13±4.37）%with navigator vs（21.15±6.78）%with freehand via SSA（P〈0.05）.The use of stereotaxic navigator resulted in less aberrance during percutaneous thoracolumbar pedicle screw placement.Conclusion The stereotaxic navigator for percutaneous thoracolumbar pedicle screw placement shows advantages in its small size,readiness for use,reliable securing and accurate angular measurement,which may be useful for hands-on training and clinical purposes.
出处
《中华生物医学工程杂志》
CAS
2011年第2期156-158,共3页
Chinese Journal of Biomedical Engineering
基金
基金项目：广东省医学科研基金（A2006275）
广州市医药卫生科技项目（2008-YB-151）
关键词
胸椎
腰椎
立体定位技术
椎弓根
经皮穿刺
Thoracic vertebrae
Lumbar vertebrae
Stereotaxic techniques
Pedicle of vertebral arch
Percutaneous puncture
