Lawson McLean Aaron, Frank Susanne, Staribacher Daniel, Kalff Rolf, Reichart Rupert
Department of Neurosurgery, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
Department of Neurosurgery, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
World Neurosurg. 2017 Sep;105:760-764. doi: 10.1016/j.wneu.2017.06.086. Epub 2017 Jun 20.
The correct positioning of spinal cord stimulator leads is assessed radiographically during their percutaneous implantation for trial stimulation. Usually the C-arm is repositioned several times to allow imaging in different planes, which may extend the total duration of surgery. The study aimed to evaluate whether the concurrent intraoperative use of 2 C-arms could safely reduce the duration of surgery.
This retrospective study included cases of percutaneous implantation of a spinal cord stimulation (SCS) lead for trial neurostimulation between 2006 and 2011. The duration of the surgical intervention was recorded, along with the duration of the preparation stage in the operating room. In addition, total radiation exposure time per case was recorded.
Ninety-four patients underwent percutaneous implantation of an SCS lead (72 thoracolumbar, 22 cervical). In 73 cases 2 C-arms were used, with 21 cases performed with a single C-arm. In both the cervical and thoracolumbar groups, a biplanar configuration was associated with significant reduction in the mean length of the surgical phase, by 29 minutes (P = 0.017) and 14 minutes, respectively (P = 0.016), albeit while increasing the duration of the preoperative preparation stage. There was no significant difference in the total duration in the operating room or in the total radiation exposure time between groups.
Here we present a technical note on the use of a biplanar fluoroscopy configuration for percutaneous implantation of SCS leads. This arrangement correlated with a reduction in surgery duration without increasing total radiation exposure, representing a practical and safe adjustment to current practice.
在经皮植入脊髓刺激器电极以进行试验性刺激期间，通过影像学评估电极的正确位置。通常需要多次重新定位C形臂，以在不同平面进行成像，这可能会延长手术总时长。本研究旨在评估术中同时使用两个C形臂是否能安全缩短手术时长。
这项回顾性研究纳入了2006年至2011年间经皮植入脊髓刺激（SCS）电极以进行试验性神经刺激的病例。记录手术干预的时长以及手术室准备阶段的时长。此外，记录每个病例的总辐射暴露时间。
94例患者接受了SCS电极的经皮植入（72例为胸腰椎，22例为颈椎）。73例使用了两个C形臂，21例使用单个C形臂。在颈椎组和胸腰椎组中，双平面配置均与手术阶段平均时长的显著缩短相关，分别缩短了29分钟（P = 0.017）和14分钟（P = 0.016），尽管术前准备阶段的时长有所增加。两组在手术室总时长或总辐射暴露时间方面无显著差异。
在此，我们介绍一种关于使用双平面荧光透视配置经皮植入SCS电极的技术说明。这种配置与手术时长的缩短相关，且未增加总辐射暴露，是对当前实践的一种实用且安全的调整。
