Patel P S D, Aspinwall E M, Fennell A J, Trotman S G, Shepherd D E T, Hukins D W L
School of Mechanical Engineering, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
Open Biomed Eng J. 2011;5:90-7. doi: 10.2174/1874120701105010090. Epub 2011 Oct 14.
Pedicle screw (PS) malpositioning rates are high in spine surgery. This has resulted in the use of computed navigational aids to reduce the rate of malposition; but these are often expensive and limited in availability. A simple mechanical device to aid PS insertion might overcome some of these disadvantages. The purpose of this study was to determine the demand and design criteria for a simple device to aid PS placement, as well as to collect opinions and experiences on PS surgery in the UK and Ireland. A postal questionnaire was sent to 422 spinal surgeons in the UK and Ireland. 101 questionnaires were received; 67 of these (16% of total sent) contained useful information. 78% of surgeons experienced problems with PS placement. The need for a simple mechanical device to aid PS placement was expressed by 59% of respondent surgeons. The proportion of respondents that inserted PSs in the cervical spine was 14%; PSs are mainly inserted in the thoracic, lumbar and sacral spine, but potential exists for a PS placement aid for the cervical and thoracic spine. From the experiences of these 67 surgeons, there is evidence to suggest that surgeons would prefer a pedicle aid that is multiple use, one-piece, hand-held, radiolucent, unilateral and uses the line of sight principle in traditional open surgery. Based on the experiences of 67 surgeons, there is evidence to suggest that computed navigational aids are not readily used in PS surgery and that a simple mechanical device could be a better option. This paper provides useful data for improving the outcomes of spinal surgery.
在脊柱手术中，椎弓根螺钉（PS）置入位置不当的发生率很高。这导致人们使用计算机导航辅助设备来降低位置不当的发生率；但这些设备通常价格昂贵且供应有限。一种辅助PS置入的简单机械装置可能会克服其中一些缺点。本研究的目的是确定一种辅助PS置入的简单装置的需求和设计标准，并收集英国和爱尔兰关于PS手术的意见和经验。向英国和爱尔兰的422名脊柱外科医生发送了邮政调查问卷。共收到101份问卷；其中67份（占发送总数的16%）包含有用信息。78%的外科医生在PS置入方面遇到过问题。59%的受访外科医生表示需要一种辅助PS置入的简单机械装置。在颈椎置入PS的受访者比例为14%；PS主要置入胸椎、腰椎和骶椎，但颈椎和胸椎的PS置入辅助装置仍有潜在需求。从这67名外科医生的经验来看，有证据表明外科医生更喜欢一种在传统开放手术中可多次使用、一体式、手持、射线可穿透、单侧且采用视线原理的椎弓根辅助装置。基于67名外科医生的经验，有证据表明计算机导航辅助设备在PS手术中并未得到广泛应用，而一种简单的机械装置可能是更好的选择。本文为改善脊柱手术的效果提供了有用的数据。
