摘要
背景:个性化、精确化、微创化与远程化一直是外科医生所追求的目标,随着计算机技术以及影像学技术的发展,计算机辅助外科手术成为一种可能。目的:观察计算机辅助术前计划下Sky膨胀式椎体成形器治疗骨质疏松椎体压缩性骨折的临床疗效。设计、时间及地点:回顾性病例分析,于2006-01/2008-01在解放军第三○七医院骨科完成。参试者:骨质疏松椎体压缩骨折患者11例,男3例,女8例。骨折椎体共14个,其中T111个,T123个,L16个,L24个。方法:基于患者CT影像数据使用计算机辅助术前计划软件Mimics确定手术计划,在C型臂引导下Sky膨胀式椎体成形器治疗。主要观察指标:记录手术时间;采用目测类比评分进行疼痛程度评估;同时观察椎体高度变化,骨水泥的渗漏情况及有无并发症发生。结果:手术时间23～52min,每个椎体平均所需时间23min。术后平均随访8个月,疼痛症状明显减轻,目测类比评分由术前平均8.2分降低为术后的2.9分。与术前相比椎体高度恢复到正常的65%～80%。4椎体侧方软组织下有少量骨水泥渗漏,无其他并发症发生。结论:应用计算机辅助术前手术计划进行椎体成形治疗骨质疏松椎体压缩性骨折手术时间较短,治疗效果好,手术并发症发生较少,有良好的应用前景。
BACKGROUND： With the development of modem medicine, which is characterized by precision, individualization, minimal invasion and distant services, computer-assisted surgery becomes an important direction for medicine development. OBJECTIVE： To explore the efficacy and feasibility of Sky bone expander system in the treatment of osteoporofic vertebral compression fi-acture with computer-assisted preoperative planning. DESIGN, TIME AND SETTING： A retrospective case analysis was performed at the Department of Orthopaedics, the 307 Hospital of Chinese PLA from January 2006 to January 2008. PARTICIPANTS： Totally 11 patients （14 fractural vertebrae） with osteoporotic vertebral compression fracture were selected, including 3 males and 8 females. Of the fractural vertebrae, there was 1 involved T11, 3 involved TI2, 6 involved LI and 4 involved Ira. METHODS： Using computer-assisted preoperative planning software （Mimics） based on real data, the patients were treated by Sky bone expander system under C-arm fluoroscopy monitoring. MAIN OUTCOME MEASURES： Operational duration; clinical assessment by visual analog scale; percentage height restored, the leakage of PMMA and the complication by preoperative and postoperative radiographs. RESULTS： The surgery lasted for 23-52 minutes, with an average time of 23 minutes for each vertebra. During the 8 months of follow up, the pain was significantly relieved, and the mean pain scores were improved from 8.2 to 2.9. Vertebral heights were improved 65% 80% after the surgery. Extravertebral leakage of bone cement was observed in 4 vertebrae body. No other complications were found in all patients. CONCLUSION： The computer-assisted preoperative planning of vertebroplasty exhibits short surgery duration, favorable treatment effect, few complications, and promising application in treating osteoporotic vertebral compression fracture.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第48期9423-9426,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
