经皮内镜椎间孔入路椎间盘切除术的等中心导航：一项可行性研究。
Isocentric Navigation for the Training of Percutaneous Endoscopic Transforaminal Discectomy: A Feasibility Study.
机构信息
Orthopedics Department, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Orthopedics Department, Zhangjiagang City Hospital of Traditional Chinese Medicine, Jiangsu, China.
出版信息
Biomed Res Int. 2018 Jul 15;2018:6740942. doi: 10.1155/2018/6740942. eCollection 2018.
BACKGROUND
Percutaneous endoscopic transforaminal discectomy (PETD) is usually chosen for lumbar disc herniation due to its obvious advantages such as small incision and absence of nerve or muscular traction. However, learning PETD is a great challenge for inexperienced surgeons.
OBJECTIVE
The study aimed to investigate whether isocentric navigation would be beneficial in PETD training.
METHODS
A total of 117 inexperienced surgeons were trained with PETD at L2/3, L3/4, L4/5, and L5/S1 on the cadavers without (Group A n=58) or with (Group B n=59) isocentric navigation. Puncture times, fluoroscopy times, exposure time, and radiation dose were recorded and analyzed. Questionnaires were conducted before and after the training program.
RESULT
Isocentric navigation could improve young surgeons' satisfaction with the training program and decrease the puncture times, fluoroscopy times, exposure time, and radiation dose significantly (P<0.001).
CONCLUSION
Isocentric navigation contributes to the training of PETD and may improve its standardization, homogenization, and generalization.
背景
经皮内窥镜下椎间孔入路椎间盘切除术（PETD）由于切口小、无神经或肌肉牵拉伤等明显优势，通常被选择用于治疗腰椎间盘突出症。然而，对于缺乏经验的外科医生来说，学习 PETD 是一个巨大的挑战。
目的
本研究旨在探讨等中心导航是否有益于 PETD 培训。
方法
在尸体上对 117 名缺乏经验的外科医生进行 L2/3、L3/4、L4/5 和 L5/S1 的 PETD 培训，无（A 组，n=58）或有（B 组，n=59）等中心导航。记录并分析穿刺次数、透视次数、曝光时间和辐射剂量。在培训计划前后进行问卷调查。
结果
等中心导航可以提高年轻外科医生对培训计划的满意度，并显著降低穿刺次数、透视次数、曝光时间和辐射剂量（P<0.001）。
结论
等中心导航有助于 PETD 的培训，可能提高其标准化、同质化和普及化。
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