Wu Meng-Huang, Dubey Navneet Kumar, Lee Ching-Yu, Li Yen-Yao, Cheng Chin-Chang, Shi Chung-Sheng, Huang Tsung-Jen
Department of Orthopedic Surgery, Taipei Medical University Hospital, Taipei, Taiwan; Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan.
Biomed Res Int. 2017;2017:2302395. doi: 10.1155/2017/2302395. Epub 2017 Feb 16.
This study was aimed at evaluating the safety and efficacy of using intraoperative computed tomography- (iCT-) guided navigation in simultaneous minimally invasive anterior and posterior surgery for infectious spondylitis. Nine patients with infectious spondylitis were enrolled in this study. The average operative time was 327.6 min (range, 210-490) and intraoperative blood loss was 407 cc (range, 50-1,200). The average duration of hospital stay was 48.9 days (range, 11-76). Out of a total of 54 pedicle screws employed, 53 screws (98.1%) were placed accurately. A reduced visual analog scale on back pain (from 8.2 to 2.2) and Oswestry disability index (from 67.1% to 25.6%) were found at the 2-year follow-up. All patients had achieved resolution of spinal infection with reduced average erythrocyte sedimentation rate (from 83.9 to 14.1 mm/hr) and average C-reactive protein (from 54.4 to 4.8 mg/dL). Average kyphotic angle correction was 10.5° (range, 8.4°-12.6°) postoperatively and 8.5° (range, 6.9°-10.1°) after 2 years. In conclusion, the current iCT-guided navigation approach has been demonstrated to be an alternative method during simultaneous minimally invasive anterior and posterior surgery for infectious spondylitis. It can provide a good intraoperative orientation and visualization of anatomic structures and also a high pedicle screw placement accuracy in patient's lateral decubitus position.
本研究旨在评估术中计算机断层扫描（iCT）引导下导航在感染性脊柱炎同期微创前后路手术中的安全性和有效性。本研究纳入了9例感染性脊柱炎患者。平均手术时间为327.6分钟（范围210 - 490分钟），术中失血量为407毫升（范围50 - 1200毫升）。平均住院时间为48.9天（范围11 - 76天）。在总共使用的54枚椎弓根螺钉中，53枚（98.1%）置入准确。在2年随访时，背痛视觉模拟评分降低（从8.2降至2.2），奥斯维斯特里功能障碍指数降低（从67.1%降至25.6%）。所有患者的脊柱感染均已消除，平均红细胞沉降率降低（从83.9降至14.1毫米/小时），平均C反应蛋白降低（从54.4降至4.8毫克/分升）。术后平均后凸角矫正为10.5°（范围8.4° - 12.6°），2年后为8.5°（范围6.9° - 10.1°）。总之，目前的iCT引导下导航方法已被证明是感染性脊柱炎同期微创前后路手术中的一种替代方法。它可以在患者侧卧位时提供良好的术中定位和解剖结构可视化，并且椎弓根螺钉置入准确性高。
