摘要
目的探讨徒手与在计算机导航下行中上胸椎骨折脱位椎弓根螺钉内固定的安全性和可行性。方法自2002年11月～2006年11月,笔者应用椎弓根螺钉内固定治疗中上胸椎骨折脱位32例,随机分为两组,一组徒手椎弓根螺钉内固定17例,另一组在三维成像C型臂(Iso-3D)导航下椎弓根螺钉内固定15例,两组行前瞻性对比研究。结果徒手行椎弓根螺钉内固定置入椎弓根螺钉122枚,穿破椎弓根内壁13枚;在计算机导航下行椎弓根螺钉内固定置入椎弓根螺钉110枚,穿破椎弓根内壁3枚。对穿破椎弓根内壁方面行t检验,两组有显著性差异(P<0.05)。结论①在C型臂X线机监视下,由有经验的脊柱外科医师徒手行胸椎弓螺钉内固定术是安全的、可行的。②在上胸椎行椎弓根螺钉内固定以导航技术辅助为宜。③导航技术只是一种利于置入物精确控制的辅助手段,不能盲目依赖,尚需结合术者的经验。
Objective To investigate the clinical safety and practicability of free hand and computer-assisted pedicle screw internal fixation of middle-upper thoracic fracture and dislocation. Methods From November 2002 to November2006, a prospective contrast study was performed on 32 cases of middle-upper thoracic fracture and dislocation treated with pedicle screw internal fixation, of 17 cases by free hand and 15cases by Iso-C3Dnavigation system.Results There were 122 pedicle screws treated implanting pedicle by free hand,of 13 perforating pedicle intines.There were 110 pedicle screws by Iso-C3D navigation system,of 3 perforating pedicle intincs. There were significant differences （P〈0.05）.Conclusion （1）Pedicle screw placement in the middle-upper thoracic fracture and dislocation by free hand is safe and feasible. （2）Application of the navigation system in the T1 to T4 can ensure the accurate placement of pedicle screws and avoid relational complication. （3）Navigation technology is only a kind of assisted device of accuracy control the insert, and need combine with the operator＇s experience.
出处
《中国骨与关节损伤杂志》
2010年第9期778-780,共3页
Chinese Journal of Bone and Joint Injury
关键词
胸椎骨折
脱位
计算机
导航
Thoracic fracture
Dislocation
Computer
Navigation
