摘要
目的:探讨天玑骨科手术导航在脊柱畸形矫形术中的临床应用价值。方法:纳入2019年12月至2021年3月,本院接受脊柱畸形矫形术患者47例,其中天玑导航组19例、徒手置钉组28例,记录两组患者术中平均每钉置钉时间、手术时间、辐射剂量,根据术后椎体CT扫描,参照Gertzbein-Robbins分级标准评价螺钉置入准确度,统计并分析结果。结果:两组患者在年龄、性别、病因学、椎体旋转程度等一般资料方面差异无统计学意义(P>0.05),具有可比性。天玑导航组置钉共179枚,平均每钉置钉时间及手术时间分别为(3.65±1.72)min和(280.87±23.82)min,徒手置钉组共置入282枚,平均每钉置钉时间及手术时间分别为(3.37±2.05)min和(276.57±26.05)min,差异无统计学意义(P>0.05)。天玑导航组的置钉优良率为98.8%(177/179),明显高于徒手置入组的88.6%(250/282),两者优良率差异有统计学意义(P<0.05)。天玑导航组置钉总误置率为1.1%(2/179)),低于徒手置钉组的11.3%(32/282),差异有统计学意义(P<0.01)。术后天玑导航组患者无神经症状,无调整螺钉,徒手组2例患者进行二次调钉。天玑导航组术中放射剂量为(43.38±5.56)mGy,徒手置钉组术中放射剂量为(34.73±6.57)mGy,差异有统计学意义(P<0.05)。结论:天玑骨科手术导航辅助置钉在脊柱畸形矫形术中应用,可提升椎弓根螺钉置钉精确度与安全性。
Objective:To explore the clinical value of Tianji orthopedic surgical navigation and positioning system in spinal deformity correction.Methods:47 patients who underwent spinal deformity correction from December 2019 to March 2021 were included including tianji navigation group(19 cases)and unarmed nail group(28 cases).The average nail placement time,operation time and radiation dose of the two groups were recorded.The accuracy of screw placement was evaluated according to postoperative vertebral CT scanning and Gertzbein-Robbins grading standard,and the results were counted and analyzed.Results:The general data of age,gender,etiology and degree of vertebral rotation between the two groups were comparable(P>0.05).179 nails were placed in the Tianji navigation group,and the average nail placement time and operation time were(3.65±1.72)min and(280.87±23.82)min respectively.A total of 282 nails were placed by hand,and the average nail placement time and operation time were(3.37±2.05)min and(276.57±26.05)min respectively(P>0.05).The excellent and good rate of nail placement in Tianji navigation group was 98.8%(177/179),which was significantly higher than 88.6%(250/282)in freehand placement group(P<0.05).The total error rate of nail placement in Tianji navigation group was 1.1%(2/179),which was lower than 11.3%(32/282)in manual nail placement group with significant difference(P<0.01).After operation,the patients in Tianji navigation group had no neurological symptoms and no adjusting screws.2 patients in the unarmed group underwent secondary adjusting screws.The intraoperative radiation dose of Tianji navigation group was(43.38±5.56)mGy and that of unarmed group was(34.73±6.57)mGy.The difference was statistically significant(P<0.05).Conclusion:The application of Tianji orthopedic navigation assisted screw placement in spinal deformity correction can improve the accuracy and safety of pedicle screw placement.
作者
李军杰
邓强
杨镇源
张彦军
王雨榕
罗林钊
韩俊秋
LI Junjie;DENG Qiang;YANG Zhenyuan;ZHANG Yanjun;WANG Yurong;LUO Linzhao;HAN Junqiu(Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050,China;Gansu University of Chinese Medicine,Lanzhou 730030,China)
出处
《中国中医骨伤科杂志》
CAS
2022年第1期19-24,共6页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
2021年甘肃省自然科学基金(20JR10RA356)。
关键词
手术导航定位
脊柱畸形
椎弓根螺钉置入
精准度
安全性
辐射剂量
surgical navigation and positioning
spinal deformity
pedicle screw placement
accuracy
safety
radiation dosage
