Yu Tong, Zheng Shuang, Zhang Xiwen, Wang Dongsheng, Kang Mingyang, Dong Rongpeng, Qu Yang, Zhao Jianwu
Department of Orthopedics.
Department of Gynaecology, The Second Hospital of Jilin University, Changchun, Jilin Province, China.
Medicine (Baltimore). 2019 Feb;98(7):e14548. doi: 10.1097/MD.0000000000014548.
The purpose of this study was to assess the accuracy of percutaneous sacroiliac screw (PSS) placement assisted by screw view model of navigation system for treatment of sacroiliac fractures.Data pertaining to 18 consecutive patients with posterior pelvic ring fracture who received sacroiliac screw fixation between January 2015 and July 2018 at the Second Hospital of Jilin University were retrospectively analyzed. Kirschner wires were placed under the guidance of navigation's screw view mode. The position of the screws was evaluated by computed tomography (CT) scan postoperatively. Fracture dislocation of sacroiliac joint was measured in axial, sagittal, and coronal views of 3 dimensional (3D) CT images preoperatively, postoperatively and at the last follow-up visit. The duration of trajectory planning, guide wire implantation time, screw placement time, intraoperative blood loss, and incidence of screw loosening and clinical complications were also assessed.A total of 27 screws were placed unilaterally or bilaterally into segments S1 or S2. Screw placement was rated as excellent for 88.9% of screws (n = 24), good for 7.4% (n = 2), and poor for 3.7% (n = 1). Preoperatively, the average fracture dislocation of sacroiliac joint on axial, sagittal, and coronal views was 14.3 mm, 9.6 mm, and 7.4 mm, respectively, and the corresponding postoperative figures were 5.6 mm, 3.2 mm, 4.1 mm, respectively. The corresponding correction rates were 60.8%, 66.7%, and 44.6%, respectively. The mean duration of trajectory planning was 6.5 min (2.7-8.9 min). Mean screw implantation time was 32 min (range, 20-53 min), and the mean guide wire implantation time was 3.7 min (range, 2.1-5.3 min). No clinical complications such as neurovascular injury, infection or screw loosening were observed on follow-up.The PSS placement under guidance of screw view model of navigation is a convenient, safe and reliable method.
本研究旨在评估导航系统螺钉视图模型辅助下经皮骶髂螺钉（PSS）置入治疗骶髂关节骨折的准确性。回顾性分析2015年1月至2018年7月在吉林大学第二医院接受骶髂螺钉固定的18例连续骨盆后环骨折患者的数据。在导航的螺钉视图模式引导下置入克氏针。术后通过计算机断层扫描（CT）评估螺钉位置。在术前、术后及末次随访时，在三维（3D）CT图像的轴位、矢状位和冠状位上测量骶髂关节的骨折脱位情况。还评估了轨迹规划时间、导丝置入时间、螺钉置入时间、术中出血量以及螺钉松动和临床并发症的发生率。
共将27枚螺钉单侧或双侧置入S1或S2节段。88.9%（n = 24）的螺钉置入评级为优秀，7.4%（n = 2）为良好，3.7%（n = 1）为差。术前，骶髂关节在轴位、矢状位和冠状位上的平均骨折脱位分别为14.3mm、9.6mm和7.4mm，术后相应数值分别为5.6mm、3.2mm、4.1mm。相应的矫正率分别为60.8%、66.7%和44.6%。轨迹规划的平均时间为6.5分钟（2.7 - 8.9分钟）。平均螺钉置入时间为32分钟（范围20 - 53分钟），平均导丝置入时间为3.7分钟（范围2.1 - 5.3分钟）。随访时未观察到神经血管损伤、感染或螺钉松动等临床并发症。
导航系统螺钉视图模型引导下的PSS置入是一种方便、安全且可靠的方法。
