The accuracy and safety of pedicle screw insertion was markedly improved with the introduction of intraoperative three-dimensional navigation system during the last decade.This study aimed to evaluate the accuracy of ...The accuracy and safety of pedicle screw insertion was markedly improved with the introduction of intraoperative three-dimensional navigation system during the last decade.This study aimed to evaluate the accuracy of pedicle screw placement using O-arm-based navigation system versus conventional freehand technique.Methods:We reviewed the accuracy of 341 thoracic(n=173)and lumbosacral(n=168)pedicle screws placed in 60 consecutive patients using either O-arm-based navigation or freehand technique in the Department of Neurosurgery of Beijing Tsinghua Changgung Hospital between January 2015 and June 2018.Patient-specific characteristics,treatment-related characteristics,and screw-specific accuracy were analyzed.The accuracy of pedicle screw placement was measured by Gertzbein-Robbins scale and screw grades A and B were clinically acceptable.Results:One hundred ninety-one screws were inserted in the O-arm-based navigation group and 150 in the freehand group.One hundred eighty-three(95.81%)clinically acceptable screws were placed in the navigation group and 135(90.00%)in the freehand group(p=0.034).Twenty-three(6.74%)screw revisions were performed in the two groups(8 screws in the navigation group and 15 screws in the freehand group)and significant difference was observed in thoracic spine(p=0.018),while no statistical significance was presented in lumbosacral spine(p>0.05).Twenty-four(12.57%)screws in the navigation group and 24(16.00%)in the freehand group violated the cortex(p>0.05).Medial screw deviation was the most common problem in the two groups.Conclusion:The O-arm-based navigation exhibits higher accuracy for pedicle screw insertion than the freehand insertion technique.展开更多
This study explored the combined use of the O-arm and real-time navigation during spinal fixation. The clinical data for 60 patients undergoing spinal fixation, at Beijing Tsinghua Chang Gung Hospital between May 5, 2...This study explored the combined use of the O-arm and real-time navigation during spinal fixation. The clinical data for 60 patients undergoing spinal fixation, at Beijing Tsinghua Chang Gung Hospital between May 5, 2015 and May 1, 2017, were retrospectively analyzed. Pre-, intra-, and postoperative imaging findings were assessed. The patients were classified into the occipitocervical fusion(32 cases) and thoracic/lumbar/sacral spine fixation(28 cases, including 6 cases of percutaneous pedicle screw) groups. Lesion resections were performed microscopically. An O-arm, combined with real-time navigation, was used to assess spinal fixation. Efficacy was evaluated using operative times, X-ray times, screw positioning, and complications. Within the occipitocervical fusion group, 182 screws were placed in the cervical spine and 96 in the occipital bone. However, 6 screws penetrated the bone cortex and were adjacent to the vertebral arteries, based on O-arm three-dimensional imaging; therefore, the precision rate was 96.7%. Within the thoracic/lumbar/sacral spine fixation group, 148 pedicle screws were implanted, with 4 initially outside the vertebral body,yielding a precision rate of 97.3%. Ten percutaneous pedicle screws were implanted and well positioned. O-arm scans were performed 3 times/patient, with an average of 20–30 min/time. Screw implantation times were 5–7 min(cervical spine), 8–10 min(thoracic spine), and 6–8 min(lumbar spine). Intraoperative O-arm scans, combined with real-time navigation technology, allow real-time observation of screw angles and depths, improving the accuracy and safety of posterior screw fixations and reducing the radiation dose and frequency experienced by patients and surgeons.展开更多
目的:探讨手术机器人联合O臂导航系统微创治疗对髋关节置换术患者出院准备度的影响。方法:选取2021年1月-2023年12月在西安交通大学第一附属医院接受手术机器人联合O臂导航系统微创治疗的200例髋关节置换术患者作为研究对象,采用自制一...目的:探讨手术机器人联合O臂导航系统微创治疗对髋关节置换术患者出院准备度的影响。方法:选取2021年1月-2023年12月在西安交通大学第一附属医院接受手术机器人联合O臂导航系统微创治疗的200例髋关节置换术患者作为研究对象,采用自制一般资料调查问卷、出院准备度量表(RHDS)、视觉模拟评分法(VAS)和慢性病自我效能量表(CDSES)评估影响患者出院准备度的因素。结果:患者的出院准备度总分为(180.95±18.97)分;出院指导质量与出院准备度之间具有显著相关性(P<0.05)。单因素分析显示,婚姻状况、教育程度、术前并发症、术后24 h VAS评分和CDSES总分对出院准备度有显著影响(P<0.05)。多元回归分析表明,教育程度、术前并发症和CDSES总分是影响患者出院准备度的重要因素(P<0.05)。结论:教育水平较高、无术前并发症和自我效能感高的患者出院准备度更高。在临床护理中,应重点关注教育水平较低、术前存在并发症以及自我效能感较低的患者,通过个性化的健康教育、心理支持和社会支持等多种干预措施,提升其出院准备度,促进术后康复。展开更多
基金the National Natural Science Foundation of China(grant 81472817).
文摘The accuracy and safety of pedicle screw insertion was markedly improved with the introduction of intraoperative three-dimensional navigation system during the last decade.This study aimed to evaluate the accuracy of pedicle screw placement using O-arm-based navigation system versus conventional freehand technique.Methods:We reviewed the accuracy of 341 thoracic(n=173)and lumbosacral(n=168)pedicle screws placed in 60 consecutive patients using either O-arm-based navigation or freehand technique in the Department of Neurosurgery of Beijing Tsinghua Changgung Hospital between January 2015 and June 2018.Patient-specific characteristics,treatment-related characteristics,and screw-specific accuracy were analyzed.The accuracy of pedicle screw placement was measured by Gertzbein-Robbins scale and screw grades A and B were clinically acceptable.Results:One hundred ninety-one screws were inserted in the O-arm-based navigation group and 150 in the freehand group.One hundred eighty-three(95.81%)clinically acceptable screws were placed in the navigation group and 135(90.00%)in the freehand group(p=0.034).Twenty-three(6.74%)screw revisions were performed in the two groups(8 screws in the navigation group and 15 screws in the freehand group)and significant difference was observed in thoracic spine(p=0.018),while no statistical significance was presented in lumbosacral spine(p>0.05).Twenty-four(12.57%)screws in the navigation group and 24(16.00%)in the freehand group violated the cortex(p>0.05).Medial screw deviation was the most common problem in the two groups.Conclusion:The O-arm-based navigation exhibits higher accuracy for pedicle screw insertion than the freehand insertion technique.
基金Supported by the Beijing Tsinghua Changgung Hospital Fund(No.12015C1045)
文摘This study explored the combined use of the O-arm and real-time navigation during spinal fixation. The clinical data for 60 patients undergoing spinal fixation, at Beijing Tsinghua Chang Gung Hospital between May 5, 2015 and May 1, 2017, were retrospectively analyzed. Pre-, intra-, and postoperative imaging findings were assessed. The patients were classified into the occipitocervical fusion(32 cases) and thoracic/lumbar/sacral spine fixation(28 cases, including 6 cases of percutaneous pedicle screw) groups. Lesion resections were performed microscopically. An O-arm, combined with real-time navigation, was used to assess spinal fixation. Efficacy was evaluated using operative times, X-ray times, screw positioning, and complications. Within the occipitocervical fusion group, 182 screws were placed in the cervical spine and 96 in the occipital bone. However, 6 screws penetrated the bone cortex and were adjacent to the vertebral arteries, based on O-arm three-dimensional imaging; therefore, the precision rate was 96.7%. Within the thoracic/lumbar/sacral spine fixation group, 148 pedicle screws were implanted, with 4 initially outside the vertebral body,yielding a precision rate of 97.3%. Ten percutaneous pedicle screws were implanted and well positioned. O-arm scans were performed 3 times/patient, with an average of 20–30 min/time. Screw implantation times were 5–7 min(cervical spine), 8–10 min(thoracic spine), and 6–8 min(lumbar spine). Intraoperative O-arm scans, combined with real-time navigation technology, allow real-time observation of screw angles and depths, improving the accuracy and safety of posterior screw fixations and reducing the radiation dose and frequency experienced by patients and surgeons.
文摘目的:探讨手术机器人联合O臂导航系统微创治疗对髋关节置换术患者出院准备度的影响。方法:选取2021年1月-2023年12月在西安交通大学第一附属医院接受手术机器人联合O臂导航系统微创治疗的200例髋关节置换术患者作为研究对象,采用自制一般资料调查问卷、出院准备度量表(RHDS)、视觉模拟评分法(VAS)和慢性病自我效能量表(CDSES)评估影响患者出院准备度的因素。结果:患者的出院准备度总分为(180.95±18.97)分;出院指导质量与出院准备度之间具有显著相关性(P<0.05)。单因素分析显示,婚姻状况、教育程度、术前并发症、术后24 h VAS评分和CDSES总分对出院准备度有显著影响(P<0.05)。多元回归分析表明,教育程度、术前并发症和CDSES总分是影响患者出院准备度的重要因素(P<0.05)。结论:教育水平较高、无术前并发症和自我效能感高的患者出院准备度更高。在临床护理中,应重点关注教育水平较低、术前存在并发症以及自我效能感较低的患者,通过个性化的健康教育、心理支持和社会支持等多种干预措施,提升其出院准备度,促进术后康复。
