Department of Spine Surgery, Park-Krankenhaus, Leipzig, Germany.
Eur Spine J. 2011 Jun;20(6):875-81. doi: 10.1007/s00586-010-1683-4. Epub 2011 Jan 21.
Transpedicular screw fixation has been accepted worldwide since Harrington et al. first placed pedicle screws through the isthmus. In vivo and in vitro studies indicated that pedicle screw insertion accuracy could be significantly improved with image-assisted systems compared with conventional approaches. The O-arm is a new generation intraoperative imaging system designed without compromise to address the needs of a modern OR like no other system currently available. The aim of our study was to check the accuracy of O-arm based and S7-navigated pedicle screw implants in comparison to free-hand technique described by Roy-Camille at the lumbar and sacral spine using CT scans. The material of this study was divided into two groups, free-hand group (group I) (30 patients; 152 screws) and O-arm group (37 patients; 187 screws). The patients were operated upon from January to September 2009. Screw implantation was performed during PLIF or TLIF mainly for spondylolisthesis, osteochondritis and post-laminectomy syndrome. The accuracy rate in our work was 94.1% in the free-hand group compared to 99% in the O-arm navigated group. Thus it was concluded that free-hand technique will only be safe and accurate when it is in the hands of an experienced surgeon and the accuracy of screw placement with O-arm can reach 100%.
经寰枢关节置入椎弓根螺钉固定技术自 Harrington 等首次报道以来，已在全球范围内得到认可。体内和体外研究表明，与传统方法相比，图像辅助系统可显著提高椎弓根螺钉置入的准确性。O 臂是新一代术中成像系统，其设计没有任何妥协，可以满足现代手术室的需求，是目前尚无其他系统能够满足的。我们的研究目的是通过 CT 扫描检查 O 臂和 S7 导航椎弓根螺钉植入术与 Roy-Camille 描述的徒手技术在腰椎和骶骨的准确性。本研究的材料分为两组，徒手组（I 组）（30 例；152 枚螺钉）和 O 臂组（37 例；187 枚螺钉）。患者于 2009 年 1 月至 9 月进行手术。PLIF 或 TLIF 主要用于脊椎滑脱、骨软骨炎和椎板切除术后综合征。我们的工作中的准确率在徒手组为 94.1%，而在 O 臂导航组为 99%。因此，结论是只有经验丰富的外科医生才能安全且准确地使用徒手技术，而 O 臂的螺钉放置准确性可以达到 100%。
