[C型臂透视或三维导航系统辅助下颈椎椎弓根螺钉内固定的临床对比]

[Clinical contrast of cervical pedicle screw fixation assisted by C-arm fluoroscopy or 3D navigation system].

作者信息

Tian Wei, Liu Ya-jun, Liu Bo, Li Qin, Hu Lin, Li Zhi-yu, Yuan Qiang

机构信息

Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2006 Oct 15;44(20):1399-402.

PMID:17217832

Abstract

OBJECTIVE

To evaluate the feasibility and accuracy of cervical (C(2)-C(7)) pedicle screw fixation assisted by C-arm fluoroscopy or 3D navigation system (CT-based navigation system or Iso-C 3D navigation system).

METHODS

One hundred and forty-five cervical pedicle screws inserted with C-arm fluoroscopy and 187 pedicle screws inserted with 3D navigation system were observed by postoperative CT or Iso-C 3D scan. The process of navigation was investigated.

RESULTS

In the 145 screws inserted with C-arm fluoroscopy, 133 screws are accurate (91.7%), and in the 187 screws inserted by 3D navigation system, 183 screws are accurate (97.9%) (chi2 = 6.705, P = 0.010), and the 4 misplaced screws occurred in the early stage of navigation system application. The process of navigation was investigated in twenty-five patients. With CT-based navigation, the mean time for registration and surface matching was 3.5 minutes; with Iso-C 3D navigation, the mean time for images collection and transfer was 6.2 minutes. The mean time for screw-marker insertion was 2 minutes.

CONCLUSIONS

3D navigation system can increase accuracy of cervical pedicle screw fixation obviously.

摘要

目的

评估在C形臂透视或3D导航系统（基于CT的导航系统或Iso-C 3D导航系统）辅助下进行颈椎（C2-C7）椎弓根螺钉固定的可行性和准确性。

方法

术后通过CT或Iso-C 3D扫描观察145枚在C形臂透视辅助下置入的颈椎椎弓根螺钉和187枚在3D导航系统辅助下置入的椎弓根螺钉。对导航过程进行研究。

结果

在145枚在C形臂透视辅助下置入的螺钉中，133枚准确（91.7%）；在187枚在3D导航系统辅助下置入的螺钉中，183枚准确（97.9%）（χ2 = 6.705，P = 0.010），4枚置放错误的螺钉出现在导航系统应用的早期阶段。对25例患者的导航过程进行了研究。基于CT的导航中，注册和表面匹配的平均时间为3.5分钟；Iso-C 3D导航中，图像采集和传输的平均时间为6.2分钟。螺钉标记置入的平均时间为2分钟。