Department of Orthopedics, General Hospital of Northern Theater Command, Shenyang, China.
Dalian Medical University, Dalian, China.
Orthop Surg. 2023 Dec;15(12):3309-3316. doi: 10.1111/os.13824. Epub 2023 Oct 9.
Percutaneous vertebroplasty (PVP) is currently the primary minimally invasive surgical approach for treating vertebral compression fractures caused by senile osteoporosis. The current existing problem is the lack of research on the application of a specific set of intraoperative C-arm fluoroscopy terminologies in PVP. Therefore, the purpose of this study is to explore the use of a specific set of intraoperative C-arm fluoroscopic terminologies in PVP in order to increase fluoroscopy accuracy, decrease fluoroscopy frequencies and ray protection, and minimize operation times through rapid preoperative training of surgeons and radiographers.
Spine surgeons and radiographers with at least 5 years of experience from nine different hospitals were randomly selected for a series of specialized intraoperative C-arm fluoroscopy terminology training between October 2018 and December 2021. Before and after the training, they were surveyed using a five-point Likert scale to statistically compare their knowledge of the terminology. Simultaneously, 190 PVP cases completed by these surgeons and radiographers before and after the training were chosen for comparison and analysis of fluoroscopy times, effective fluoroscopy rate, fluoroscopy time, repeated puncture rate, and other indicators before and after receiving specialized terminology training. Two-sample tests were mainly used to investigate differences in answers between surgeons and radiographers.
After the training, there was a notable improvement in the fluency of intraoperative communication between professional spine surgeons and radiographers. By comparing the indicators of pre-training with post-training, the effective anteroposterior fluoroscopy rate increased from 46.5% to 75.7%; the effective lateral fluoroscopy rate increased from 59.8% to 76.9%. Moreover, a notable decrease in communication barriers, fluoroscopy frequencies, fluoroscopy time, and the rate of repeated punctures, and a notable increase in the effective fluoroscopy rate was observed.
Smooth intraoperative communication between professional spine surgeons and radiographers can significantly lower the communication barrier, reduce the fluoroscopy frequencies and time, the rate of repeated puncture, and increase the effective fluoroscopy rate, all of which are important in improving the fluoroscopy in PVP.
经皮椎体成形术（PVP）是目前治疗老年骨质疏松性椎体压缩性骨折的主要微创外科方法。目前存在的问题是缺乏对 PVP 中特定一套术中 C 臂透视术术语应用的研究。因此，本研究旨在探讨在 PVP 中使用特定一套术中 C 臂透视术术语，以通过对脊柱外科医生和放射技师进行快速术前培训，提高透视准确性、减少透视次数和射线防护，缩短手术时间。
从 9 家不同医院中随机选择至少有 5 年经验的脊柱外科医生和放射技师参加一系列专门的术中 C 臂透视术术语培训，时间为 2018 年 10 月至 2021 年 12 月。在培训前后，采用 5 点 Likert 量表对他们的术语知识进行调查，以进行统计学比较。同时，选择这些外科医生和放射技师在培训前后完成的 190 例 PVP 病例进行比较和分析透视时间、有效透视率、透视时间、重复穿刺率等指标。主要采用两样本检验比较外科医生和放射技师的答案差异。
培训后，专业脊柱外科医生和放射技师之间的术中沟通流畅性显著提高。通过比较培训前后的指标，有效前后位透视率从 46.5%提高到 75.7%；有效侧位透视率从 59.8%提高到 76.9%。此外，还观察到沟通障碍、透视次数、透视时间和重复穿刺率显著降低，有效透视率显著提高。
专业脊柱外科医生和放射技师之间的顺畅术中沟通可以显著降低沟通障碍，减少透视次数和时间、重复穿刺率，并提高有效透视率，这些都是提高 PVP 透视效果的重要因素。
