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使用导航或传统透视进行腰椎微创腰大肌前外侧椎间融合术期间的围手术期因素比较

Comparison Perioperative Factors During Minimally Invasive Pre-Psoas Lateral Interbody Fusion of the Lumbar Spine Using Either Navigation or Conventional Fluoroscopy.

作者信息

Zhang Yue-Hui, White Ian, Potts Eric, Mobasser Jean-Pierre, Chou Dean

机构信息

University of California San Francisco, CA, USA.

Xin Hua Hospital, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Global Spine J. 2017 Oct;7(7):657-663. doi: 10.1177/2192568217716149. Epub 2017 Jul 28.

DOI:10.1177/2192568217716149
PMID:28989845
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5624381/
Abstract

STUDY DESIGN

Retrospective clinical study.

OBJECTIVES

The aim of this study was to compare intraoperative conditions and clinical results of patients undergoing pre-psoas oblique lateral interbody fusion (OLIF) using navigation or conventional fluoroscopy (C-ARM) techniques.

METHODS

Forty-two patients (22 patients by navigation and 20 by fluoroscopy) underwent the OLIF procedure at 2 medical centers, and records were reviewed. Clinical data was collected and compared between the 2 groups. Patients were followed-up with a range of 6 to 24 months.

RESULTS

There were no significant differences on demographic data between groups. The navigation group had zero radiation exposure (RE) to the surgeon and radiation time compared to the C-ARM group, with total RE of 44.59 ± 26.65 mGy and radiation time of 88.30 ± 58.28 seconds ( < .05). The RE to the patient was significantly lower in the O-ARM group (9.38 mGy) compared to the C-ARM group (44.59 ± 26.65 mGy). Operating room time was slightly longer in the navigation group (2.49 ± 1.35 hours) compared to the C-ARM group (2.30 ± 1.17 hours; > .05), although not statistically significant. No differences were found in estimated blood loss, length of hospitalization, surgery-related complications, and outcome scores with an average of 8-month follow-up.

CONCLUSIONS

Compared with C-ARM techniques, using navigation can eliminate RE to surgeon and decrease RE to the patient, and it had no significant effect on operating time, estimated blood loss, length of hospitalization, or perioperative complications in the patients with OLIF procedure. This study shows that navigation is a safe alternative to fluoroscopy during the OLIF procedure in the treatment of degenerative lumbar conditions.

摘要

研究设计

回顾性临床研究。

目的

本研究旨在比较采用导航技术或传统透视(C型臂)技术进行腰大肌前外侧斜向椎间融合术(OLIF)的患者的术中情况和临床结果。

方法

42例患者(22例采用导航技术,20例采用透视技术)在2个医疗中心接受了OLIF手术,并对记录进行了回顾。收集两组的临床数据并进行比较。对患者进行了6至24个月的随访。

结果

两组间人口统计学数据无显著差异。与C型臂组相比,导航组外科医生的辐射暴露(RE)和辐射时间为零,C型臂组的总RE为44.59±26.65mGy,辐射时间为88.30±58.28秒(P<0.05)。与C型臂组(44.59±26.65mGy)相比,O型臂组患者的RE显著更低(9.38mGy)。导航组的手术室时间(2.49±1.35小时)略长于C型臂组(2.30±1.17小时;P>0.05),尽管无统计学意义。平均随访8个月时,估计失血量、住院时间、手术相关并发症和结果评分方面未发现差异。

结论

与C型臂技术相比,使用导航可消除外科医生的辐射暴露并减少患者的辐射暴露,且对OLIF手术患者的手术时间、估计失血量、住院时间或围手术期并发症无显著影响。本研究表明,在治疗退行性腰椎疾病的OLIF手术中,导航是透视的一种安全替代方法。

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