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用于引导单侧腰椎椎弓根螺钉与对侧经椎板关节突螺钉固定的3D导航模板:多中心随机对照试验的研究方案

A 3D navigation template for guiding a unilateral lumbar pedicle screw with contralateral translaminar facet screw fixation: a study protocol for multicentre randomised controlled trials.

作者信息

Shao Zhen-Xuan, He Wei, He Shao-Qi, Lin Sheng-Lei, Huang Zhe-Yu, Tang Hong-Chao, Ni Wen-Fei, Wang Xiang-Yang, Wu Ai-Min

机构信息

Department of Spine Surgery, Orthopaedic Hospital, The Second Affiliated Hospital and Yuying Children's Hospital of the Wenzhou Medical University, The Second Medical School of the Wenzhou Medical University, Zhejiang Spine Center, Wenzhou, China.

Department of Orthopaedics, People's Hospital of Shaoxing, Zhejiang University Shaoxing Hospital, Shaoxing, China.

出版信息

BMJ Open. 2017 Jul 21;7(7):e016328. doi: 10.1136/bmjopen-2017-016328.

Abstract

INTRODUCTION

The incidence of lumbar disc degeneration disease has increased in recent years. Lumbar interbody fusion using two unilateral pedicle screws and a translaminar facet screw fixation has advantages of minimal invasiveness and lower costs compared with the traditional methods. Moreover, a method guided by a three-dimensional (3D) navigation template may help us improve the surgical accuracy and the success rate. This is the first randomised study using a 3D navigation template to guide a unilateral lumbar pedicle screw with contralateral translaminar facet screw fixation.

METHODS AND ANALYSIS

Patients who meet the criteria of the surgery will be randomly divided into experimental groups and control groups by a computer-generated randomisation schedule. We will preoperatively design an individual 3D navigation template using CATIA software and MeditoolCreate. The following primary outcomes will be collected: screw angles compared with the optimal screw trajectories in 3D digital images, length of the wound incision, operative time, intraoperative blood loss and complications. The following secondary outcomes will be collected: visual analogue scale (VAS) for back pain, VAS for leg pain and the Oswestry Disability Index. These parameters will be evaluated on day 1 and then 3, 6, 12 and 24 months postoperatively.

ETHICS AND DISSEMINATION

The study has been reviewed and approved by the institutional ethics review board of the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University. The results will be presented at scientific communities and peer-reviewed journals.

TRIAL REGISTRATION NUMBER

ChiCTR-IDR-17010466.

摘要

引言

近年来,腰椎间盘退变疾病的发病率有所上升。与传统方法相比,使用两枚单侧椎弓根螺钉和一枚经椎板关节突螺钉固定的腰椎椎间融合术具有微创和成本较低的优点。此外,一种由三维(3D)导航模板引导的方法可能有助于提高手术准确性和成功率。这是第一项使用3D导航模板引导单侧腰椎椎弓根螺钉与对侧经椎板关节突螺钉固定的随机研究。

方法与分析

符合手术标准的患者将通过计算机生成的随机分组方案随机分为实验组和对照组。我们将使用CATIA软件和MeditoolCreate术前设计个体化的3D导航模板。将收集以下主要结局指标:与3D数字图像中最佳螺钉轨迹相比的螺钉角度、伤口切口长度、手术时间、术中出血量和并发症。将收集以下次要结局指标:背痛视觉模拟量表(VAS)、腿痛VAS和Oswestry功能障碍指数。这些参数将在术后第1天以及术后3、6、12和24个月进行评估。

伦理与传播

本研究已通过温州医科大学附属第二医院育英儿童医院机构伦理审查委员会的审查和批准。研究结果将在科学界和同行评审期刊上发表。

试验注册号

ChiCTR-IDR-17010466。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e688/5642762/b909ccb18e41/bmjopen-2017-016328f01.jpg

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