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后路脊柱融合手术中电动和手动驱动器的定位性能

Positioning Performance of Power and Manual Drivers in Posterior Spinal Fusion Procedures.

作者信息

Prendergast J Micah, Perry Alexander C, Patel Vikas V, Lindley Emily M, Rentschler Mark E

机构信息

Department of Mechanical Engineering, University of Colorado at Boulder, 427 UCB, Boulder, CO 80309, USA.

University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

出版信息

Appl Bionics Biomech. 2017;2017:7262841. doi: 10.1155/2017/7262841. Epub 2017 Jul 27.

Abstract

This work presents an analysis and comparison of the efficacy of two methods for pedicle screw placement during posterior spinal fusion surgery. A total of 100 screws (64 manual and 36 power driven), all placed utilizing a surgical navigation system, were analyzed and compared. Final screw placement was compared to initial surgical plans using the navigation system, and the final screw locations were analyzed on the basis of angular deviation from these planned trajectories as well as screw translation within a critical reference plane. The power driver was found to insignificantly decrease the resulting angular deviation of these pedicle screws with a mean deviation of 3.35 degrees compared to 3.44 degrees with the manual driver ( = 0.853). Conversely, the power driver was found to increase the translational distance in the critical region, with mean deviations of 2.45 mm for the power driver compared to 1.54 mm with the manual driver. The increase in translational deviation was significant ( = 0.002) indicating that there may be some loss in performance from the adoption of the power driver.

摘要

这项研究对后路脊柱融合手术中两种椎弓根螺钉置入方法的疗效进行了分析和比较。共分析比较了100枚螺钉(64枚手动置入,36枚动力驱动置入),所有螺钉均使用手术导航系统置入。将最终螺钉置入位置与使用导航系统的初始手术计划进行比较,并根据与这些计划轨迹的角度偏差以及在关键参考平面内的螺钉平移情况分析最终螺钉位置。结果发现,动力驱动置入法可使这些椎弓根螺钉的角度偏差略有减小,平均偏差为3.35度,而手动驱动置入法的平均偏差为3.44度(P = 0.853)。相反,动力驱动置入法会增加关键区域的平移距离,动力驱动置入法的平均偏差为2.45毫米,而手动驱动置入法为1.54毫米。平移偏差的增加具有统计学意义(P = 0.002),表明采用动力驱动置入法可能会导致一定的性能损失。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff0f/5551465/a00ba3407bcb/ABB2017-7262841.001.jpg

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