Jiang Cheng-Hao, Shi Yan, Sun Yong-Mei, Cai Ming-Jun, Wu Hai-Long, Hu Li-Sheng, Yu Li-Min, Wang Peng, Shen Jie, Huang Yong-Can, Yu Bin-Sheng
Clinical College, Peking University Shenzhen Hospital, Anhui Medical University, Shenzhen 518036, China.
Shenzhen Key Laboratory of Spine Surgery, Department of Spine Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, China.
Bioengineering (Basel). 2023 Jun 25;10(7):756. doi: 10.3390/bioengineering10070756.
This study compares the accuracy and safety of pedicle screw placement using a 3D navigation template with the free-hand fluoroscopy technique in scoliotic patients. Fifteen scoliotic patients were recruited and divided into a template group (eight cases) and a free-hand group (seven cases). All patients received posterior corrective surgeries, and the pedicle screw was placed using a 3D navigation template or a free-hand technique. After surgery, the positions of the pedicle screws were evaluated using CT. A total of 264 pedicle screws were implanted in 15 patients. Both the two techniques were found to achieve satisfactory safety of screw insertion in scoliotic patients (89.9% vs. 90.5%). In the thoracic region, the 3D navigation template was able to achieve a much higher accuracy of screw than the free-hand technique (75.3% vs. 60.4%). In the two groups, the accuracy rates on the convex side were slightly higher than on the concave side, while no significance was seen. In terms of rotational vertebrae, no significant differences were seen in Grades I or II vertebrae between the two groups. In conclusion, the 3D navigation template technique significantly increased the accuracy of thoracic pedicle screw placement, which held great potential for extensively clinical application.
本研究比较了在脊柱侧凸患者中使用三维导航模板与徒手透视技术进行椎弓根螺钉置入的准确性和安全性。招募了15例脊柱侧凸患者，分为模板组（8例）和徒手组（7例）。所有患者均接受后路矫正手术，采用三维导航模板或徒手技术置入椎弓根螺钉。术后，使用CT评估椎弓根螺钉的位置。15例患者共植入264枚椎弓根螺钉。结果发现，两种技术在脊柱侧凸患者中均能实现令人满意的螺钉置入安全性（89.9%对90.5%）。在胸椎区域，三维导航模板能够实现比徒手技术更高的螺钉置入准确性（75.3%对60.4%）。两组中，凸侧的准确率略高于凹侧，但差异无统计学意义。在旋转椎体方面，两组I级或II级椎体之间无显著差异。总之，三维导航模板技术显著提高了胸椎椎弓根螺钉置入的准确性，具有广泛临床应用的巨大潜力。
