Cong Yu, Bao Nirong, Zhao Jianning, Mao Guangping
Department of Orthopedics, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China (mainland).
Med Sci Monit. 2015 Sep 8;21:2672-7. doi: 10.12659/MSM.894074.
The aim of this study was to compare the accuracy of cervical pedicle screw placement between a three-dimensional guidance system and manual manipulation.
Eighteen adult cadavers were randomized into group A (n=9) and group B (n=9). Ninety pedicle screws were placed into the C3-C7 under the guidance of a three-dimensional locator in group A, and 90 screws were inserted by manual manipulation in group B. The cervical spines were scanned using computed tomography (CT). Parallel and angular offsets of the screws were compared between the two placement methods.
In group A, 90% of the screws were within the pedicles and 10% breached the pedicle cortex. In group B, 55.6% were within the pedicle and 44.4% breached the pedicle cortex. Locator guidance showed significantly lower parallel and angular offsets in axial CT images (P<0.01), and significantly lower angular offset in sagittal CT images (P<0.01) than manual manipulation.
Locator guidance is superior to manual manipulation in accuracy of cervical screw placement. Locator guidance might provide better safety than manual manipulation in placing cervical screws.
本研究的目的是比较三维引导系统与手动操作在颈椎椎弓根螺钉置入的准确性。
18具成年尸体随机分为A组（n = 9）和B组（n = 9）。A组在三维定位器引导下于C3 - C7置入90枚椎弓根螺钉，B组通过手动操作置入90枚螺钉。使用计算机断层扫描（CT）对颈椎进行扫描。比较两种置入方法螺钉的平行和角度偏移。
A组中，90%的螺钉位于椎弓根内，10%穿破椎弓根皮质。B组中，55.6%位于椎弓根内，44.4%穿破椎弓根皮质。在轴向CT图像中，定位器引导显示的平行和角度偏移显著低于手动操作（P < 0.01），在矢状面CT图像中角度偏移也显著低于手动操作（P < 0.01）。
在颈椎螺钉置入准确性方面，定位器引导优于手动操作。在置入颈椎螺钉时，定位器引导可能比手动操作提供更好的安全性。
