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新型自行导向椎弓根攻丝器用于椎弓根螺钉置钉的可行性：一项解剖学研究。

The feasibility of a new self-guided pedicle tap for pedicle screw placement: an anatomical study.

机构信息

Department of Spine Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou Jiangsu, 221000, China.

Department of Orthopedics, The People's Hospital of Huishan, Wuxi Jiangsu, 214000, China.

出版信息

BMC Musculoskelet Disord. 2023 Jul 8;24(1):557. doi: 10.1186/s12891-023-06681-7.

DOI:10.1186/s12891-023-06681-7
PMID:37422653
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10329362/
Abstract

PURPOSE

To investigate the safety and accuracy of applying a new self-guided pedicle tap to assist pedicle screw placement.

METHODS

A new self-guided pedicle tap was developed based on the anatomical and biomechanical characteristics of the pedicle. Eight adult spine specimens, four males and four females, were selected and tapped on the left and right sides of each pair of T1-L5 segments using conventional taps (control group) and new self-guided pedicle taps (experimental group), respectively, and pedicle screws were inserted. The screw placement time of the two groups were recorded and compared using a stopwatch. The safety and accuracy of screw placement were observed by CT scanning of the spine specimens and their imaging results were graded according to the Heary grading criteria.

RESULTS

Screw placement time of the experimental group were (5. 73 ± 1. 18) min in thoracic vertebrae and (5. 09 ± 1. 31) min in lumbar vertebrae respectively. Screw placement time of the control group were respectively (6. 02 ± 1. 54) min in thoracic vertebrae and (5.51 ± 1.42) min in lumbar vertebrae. The difference between the two groups was not statistically significant (P > 0. 05). The Heary grading of pedicle screws showed 112 (82.35%) Heary grade I screws and 126 (92.65%) Heary grade I + II screws in the experimental group, while 96 (70.59%) Heary grade I screws and 112 (82.35%) Heary grade I + II screws in the control group.The difference between the two groups was statistically significant (P < 0.05).

CONCLUSION

The new self-guided pedicle tap can safely and accurately place thoracic and lumbar pedicle screws with low-cost and convenient procedure,which indicates a good clinical application value.

摘要

目的

研究一种新型自导向椎弓根丝锥辅助椎弓根螺钉置钉的安全性和准确性。

方法

根据椎弓根的解剖学和生物力学特点，研制了一种新型自导向椎弓根丝锥。选取 8 具成人脊柱标本，每对 T1-L5 节段的左侧和右侧分别使用常规丝锥（对照组）和新型自导向椎弓根丝锥（实验组）进行椎弓根丝锥攻丝，并插入椎弓根螺钉。使用秒表记录两组的螺钉放置时间，并进行比较。通过对脊柱标本进行 CT 扫描观察螺钉放置的安全性和准确性，并根据 Heary 分级标准对其影像学结果进行分级。

结果

实验组胸椎螺钉放置时间为（5.73±1.18）min，腰椎螺钉放置时间为（5.09±1.31）min；对照组胸椎螺钉放置时间分别为（6.02±1.54）min和（5.51±1.42）min。两组间差异无统计学意义（P＞0.05）。实验组椎弓根螺钉的 Heary 分级结果为 112 枚（82.35%）为 Heary Ⅰ级螺钉和 126 枚（92.65%）为 Heary Ⅰ+Ⅱ级螺钉，对照组分别为 96 枚（70.59%）为 Heary Ⅰ级螺钉和 112 枚（82.35%）为 Heary Ⅰ+Ⅱ级螺钉。两组间差异有统计学意义（P＜0.05）。

结论

新型自导向椎弓根丝锥可安全、准确地置入胸腰椎椎弓根螺钉，具有成本低、操作方便等优点，具有良好的临床应用价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e8e/10329362/def5a5b00ac4/12891_2023_6681_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e8e/10329362/4abf67a8c7c2/12891_2023_6681_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e8e/10329362/eb2b7351849b/12891_2023_6681_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e8e/10329362/94c27d06425a/12891_2023_6681_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e8e/10329362/f5544ee8c3e7/12891_2023_6681_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e8e/10329362/1b5eac102635/12891_2023_6681_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e8e/10329362/9c716d5fc14d/12891_2023_6681_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e8e/10329362/a79e99a1a44a/12891_2023_6681_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e8e/10329362/805bf10ea634/12891_2023_6681_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e8e/10329362/def5a5b00ac4/12891_2023_6681_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e8e/10329362/4abf67a8c7c2/12891_2023_6681_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e8e/10329362/eb2b7351849b/12891_2023_6681_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e8e/10329362/94c27d06425a/12891_2023_6681_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e8e/10329362/f5544ee8c3e7/12891_2023_6681_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e8e/10329362/1b5eac102635/12891_2023_6681_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e8e/10329362/9c716d5fc14d/12891_2023_6681_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e8e/10329362/a79e99a1a44a/12891_2023_6681_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e8e/10329362/805bf10ea634/12891_2023_6681_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e8e/10329362/def5a5b00ac4/12891_2023_6681_Fig9_HTML.jpg

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Accuracy of Pedicle Screw Placement and Clinical Outcomes of Robot-assisted Technique Versus Conventional Freehand Technique in Spine Surgery From Nine Randomized Controlled Trials: A Meta-analysis.基于 9 项随机对照试验的荟萃分析：机器人辅助技术与传统徒手技术在脊柱手术中椎弓根螺钉置钉准确性和临床结果的比较。
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