Assistant, Department of Neurosurgery Pavlov First Saint Petersburg State Medical University, 6-8 L'va Tolstogo St., Saint Petersburg, 197022, Russia.
PhD Student, Department of Neurosurgery Pavlov First Saint Petersburg State Medical University, 6-8 L'va Tolstogo St., Saint Petersburg, 197022, Russia.
Sovrem Tekhnologii Med. 2021;13(5):41-46. doi: 10.17691/stm2021.13.5.05. Epub 2021 Oct 29.
Subcortical screw placement is currently performed using frontal view fluoroscopy or intraoperative O-arm navigation system. The emergence of a novel technique for spinal navigation based on individual navigation templates created using 3D printing technology determines the need to study their safety and effectiveness in subcortical implantation. was to evaluate and compare the efficacy of subcortical implantation of pedicle screws in the lumbar spine using individual navigation templates versus intraoperative fluoroscopy.
The study was based on the analysis of treatment results in 39 patients who underwent surgery with subcortical implantation of 130 screws using the MidLIF technique. In group 1, navigation templates were used, in group 2 - intraoperative fluoroscopic control. Comparative analysis of implantation correctness and time, the total operation time, and radiation load was performed.
The mean distance between the screw and the cortical plate recorded in the groups ranged within 1.20-3.97 mm, without statistically significant difference (p>0.05). The mean time of pedicle screw implantation was 137.0 [115.25; 161.50] s in group 1 and 314.0 [183.50; 403.25] s in group 2. The total operation time was reduced from 173.0 [155.0; 192.25] min in group 2 to 119.0 [108.0; 128.75] min in group 1. The average of 1.0 [1.0; 2.0] X-ray image was performed to place one screw in group 1, while it was 12.0 [10.0; 13.25] in group 2. The differences between the groups in terms of implantation time and radiation load were statistically significant (p<0.05).
Compared with intraoperative fluoroscopy, the use of individual navigation templates for subcortical implantation of pedicle screws provides their correct positioning with a significant reduction in both operation time and radiation load at similar safety.
评估和比较使用个体化导航模板与术中透视进行皮质下腰椎椎弓根螺钉植入的效果。
本研究基于对 39 例采用 MidLIF 技术行皮质下植入 130 枚螺钉患者的治疗结果进行分析。组 1 使用导航模板，组 2 使用术中透视。对植入准确性和时间、总手术时间和辐射负荷进行了比较分析。
两组螺钉与皮质板之间的平均距离在 1.20-3.97mm 之间，差异无统计学意义（p>0.05）。组 1 椎弓根螺钉植入时间为 137.0[115.25；161.50]s，组 2 为 314.0[183.50；403.25]s。组 2 的总手术时间从 173.0[155.0；192.25]min 减少到组 1 的 119.0[108.0；128.75]min。组 1 放置一个螺钉的平均 X 射线图像为 1.0[1.0；2.0]张，组 2 为 12.0[10.0；13.25]张。植入时间和辐射负荷方面，两组间差异有统计学意义（p<0.05）。
与术中透视相比，个体化导航模板用于皮质下腰椎椎弓根螺钉植入可准确定位，且在不降低安全性的情况下显著缩短手术时间和降低辐射负荷。
