Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
Department of Orthopaedic surgery, Yantaishan Hospital, Yantai, China.
Orthop Surg. 2023 Nov;15(11):2855-2863. doi: 10.1111/os.13863. Epub 2023 Sep 22.
Iliosacral screw insertion by computer-assisted navigation gradually became the main technique in some hospitals, but the expensive price limited the extensive application. But other techniques such as 3D printed template was used to place iliosacral screw as novel method. This study was to compare the efficiency of percutaneous iliosacral screw placement by using patient-specific template and computer-assisted navigation.
Total of 58 patients from September 2017 to September 2021 with sacral injury were treated operatively with percutaneous screw technique, which was selected for this retrospective analysis and divided into two groups (template and computer-assisted navigation). There were 31 patients in template group and 27 patients in computer-assisted navigation group. The surgical details (operation time, blood loss, number of screw placements, and number of fluoroscopies), complications, radiographic and clinical results were recorded. The quality of reduction was assessed by the Matta scoring system. T-test and rank-sum test was used in this study.
Operation time in template group was less (33.97 ± 16.61 < 60.31 ± 11.46 min, p < 0.01), but the preoperative preparation time was more (6.35 ± 1.60 > 5.41 ± 1.58, p < 0.05). The quality of reduction in both groups was no difference (p = 0.352). A patient was complicated with gluteal vessel injury in operation in navigation group, which was treated with ligation, but the same injury was not observed in template group. The related surgical data of patient with gluteal injury was ignored in statistical analysis.
Both of the two techniques could improve surgical efficiency, the operation time in template was less than computer-assisted navigation group, but the preoperative preparation time was more.
计算机辅助导航下的髂骶螺钉置入术逐渐成为部分医院的主要技术，但昂贵的价格限制了其广泛应用。然而，其他技术，如 3D 打印模板，已被用于放置髂骶螺钉，成为一种新的方法。本研究旨在比较使用患者特异性模板和计算机辅助导航经皮髂骶螺钉置入的效率。
回顾性分析了 2017 年 9 月至 2021 年 9 月因骶骨损伤接受经皮螺钉技术手术治疗的 58 例患者，将其分为模板组（n=31）和计算机辅助导航组（n=27）。记录手术细节（手术时间、失血量、螺钉数量和透视次数）、并发症、影像学和临床结果。采用 Matta 评分系统评估复位质量。本研究采用 t 检验和秩和检验。
模板组的手术时间更短（33.97±16.61<60.31±11.46，p<0.01），但术前准备时间更长（6.35±1.60>5.41±1.58，p<0.05）。两组的复位质量无差异（p=0.352）。导航组 1 例患者术中并发臀血管损伤，行结扎治疗，但模板组未观察到相同损伤。在统计学分析中忽略了臀损伤患者的相关手术数据。
两种技术均能提高手术效率，模板组的手术时间短于计算机辅助导航组，但术前准备时间更长。
