Diepers Michael, Gruber Philipp, Remonda Luca, Berberat Jatta
Department of Neuroradiology, Kantonsspital Aarau, Aarau, Switzerland.
Front Surg. 2023 Feb 14;10:1093964. doi: 10.3389/fsurg.2023.1093964. eCollection 2023.
Computed tomography (CT)-guided infiltrations are a mainstay in the treatment of lower back pain. Needle placement is usually performed using the free-hand method, where the translation from the planned needle angle to the actual needle insertion angle is estimated. However, the free-hand method is especially challenging in cases where a double-oblique access route (out-of-plane) rather than an in-plane route is necessary. In this case series, we report our experience with the patient-mounted Cube Navigation System to guide needle placement for complex access routes in lumbar pain therapy.
We retrospectively analyzed the cases of five patients in whom a double-oblique access route was necessary for CT-guided lumbar infiltration pain treatment. Each of those procedures was done using the Cube Navigation System to provide navigational guidance. The mean patient age was 69 ± 13 years (range 58-82 years; all females). Technical success, procedure time, and number of control scans were determined retrospectively.
Technical success (i.e., positioning and accuracy) was obtained in all cases. Mean procedure time was 15 ± 7 min (10-22 min); on average, 2 ± 1 CT control scans were performed. There were no complications or material failures reported in the present study.
Double-oblique punctures with the Cube Navigation System in this initial case series of complex access routes at the lumbar spine were accurate and the procedure was time efficient. In the authors' view, the Cube Navigation System has the potential to improve needle guidance for complex access routes, especially considering the ease of use of the device.
计算机断层扫描（CT）引导下的浸润治疗是下腰痛治疗的主要手段。针的放置通常采用徒手方法，即估算从计划的针角度到实际针插入角度的平移。然而，徒手方法在需要双斜入路（平面外）而非平面内入路的情况下尤其具有挑战性。在本病例系列中，我们报告了使用患者安装的Cube导航系统在腰椎疼痛治疗中为复杂入路引导针放置的经验。
我们回顾性分析了5例需要CT引导下腰椎浸润性疼痛治疗的双斜入路患者的病例。这些手术均使用Cube导航系统提供导航引导。患者平均年龄为69±13岁（范围58 - 82岁；均为女性）。回顾性确定技术成功率、手术时间和对照扫描次数。
所有病例均取得技术成功（即定位和准确性）。平均手术时间为15±7分钟（10 - 22分钟）；平均进行2±1次CT对照扫描。本研究中未报告并发症或材料故障。
在这个腰椎复杂入路的初始病例系列中，使用Cube导航系统进行双斜穿刺准确且手术效率高。在作者看来，Cube导航系统有潜力改善复杂入路的针引导，特别是考虑到该设备的易用性。
