Spine Unit, El-Hadra University Hospital, Alexandria, Egypt.
Eur Spine J. 2013 Mar;22(3):648-53. doi: 10.1007/s00586-012-2505-7. Epub 2012 Sep 25.
Although pedicle screw fixation is a well-established technique for the lumbar spine, screw placement in the thoracic spine is more challenging because of the smaller pedicle size and more complex 3D anatomy. The intraoperative use of image guidance devices may allow surgeons a safer, more accurate method for placing thoracic pedicle screws while limiting radiation exposure. This generic 3D imaging technique is a new generation intraoperative CT imaging system designed without compromise to address the needs of a modern OR.
The aim of our study was to check the accuracy of this generic 3D navigated pedicle screw implants in comparison to free hand technique described by Roy-Camille at the thoracic spine using CT scans.
The material of this study was divided into two groups: free hand group (group I) (18 patients; 108 screws) and 3D group (27 patients; 100 screws). The patients were operated upon from January 2009 to March 2010. Screw implantation was performed during internal fixation for fractures, tumors, and spondylodiscitis of the thoracic spine as well as for degenerative lumbar scoliosis.
The accuracy rate in our work was 89.8 % in the free hand group compared to 98 % in the generic 3D navigated group.
In conclusion, 3D navigation-assisted pedicle screw placement is superior to free hand technique in the thoracic spine.
虽然经皮椎弓根螺钉固定技术已广泛应用于腰椎，但胸椎椎弓根螺钉的置入更具挑战性，因为胸椎椎弓根较小，且 3D 解剖结构更复杂。术中使用影像引导装置可使外科医生在放置胸椎椎弓根螺钉时采用更安全、更准确的方法，同时限制辐射暴露。这种通用的 3D 成像技术是一种新一代的术中 CT 成像系统，它的设计没有任何妥协，以满足现代手术室的需求。
本研究旨在通过 CT 扫描检查与 Roy-Camille 描述的徒手技术相比，这种通用的 3D 导航椎弓根螺钉植入物在胸椎中的准确性。
本研究的材料分为两组：徒手组（I 组）（18 例；108 枚螺钉）和 3D 组（27 例；100 枚螺钉）。患者于 2009 年 1 月至 2010 年 3 月接受手术。螺钉植入术用于治疗胸段骨折、肿瘤和脊椎炎以及退行性腰椎侧凸的内固定。
我们的工作中，徒手组的准确率为 89.8%，而通用 3D 导航组的准确率为 98%。
总之，3D 导航辅助椎弓根螺钉置入在胸椎中优于徒手技术。
