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一项关于使用计算机断层扫描引导下椎弓根脊柱穿刺针放置对胸椎病变进行术前定位的新方法的单中心经验。

Single-center experiences with a novel method for preoperative localization of thoracic spine lesions using computed tomography-guided pedicular spinal needle placement.

作者信息

Güvercin Ali Rıza, Bıyık Mehmet Orbay, Aktoklu Mehmet, Yazar Uğur, Çakır Ertuğrul

机构信息

Department of Neurosurgery, Karadeniz Technical University, Trabzon-Türkiye.

出版信息

Ulus Travma Acil Cerrahi Derg. 2025 Apr;31(4):371-374. doi: 10.14744/tjtes.2025.82844.

Abstract

OBJECTIVE

Thoracic level localization in the treatment of thoracic spine problems is more challenging than other spinal regions. The purpose of this study was to prove the reliability of pedicular spinal needle placement under computed tomography guidance before thoracic spine surgery and to reduce the margin of error, surgery time and operating room radiation exposure during thoracic spine and spinal cord surgery.

METHODS

Fourteen patients undergoing posterior aproach to the thoracic spine and/or spinal cord related lesions were investigated. Spinocaths were placed under CT guidance, into the pedicle of the relevant vertebra, at the same day or the night before surgery. The surgical field is prepared as usual, and a spinocath is placed to the relevant thoracic pedicle under CT guidance.

RESULTS

Intraoperative level localization was more reliable and easier in patients undergoing preoperative CT-guided marking in surgeries on the thoracic region performed for various reasons. Shorter preoperative preparation and intraoperative anesthesia times, a decrease in number of fluoroscopic images taken intraoperatively, and no spinal mislocalizations were observed.

CONCLUSION

The results obtained suggest that localising the level with preoperative CT before all types of thoracic surgery is a safe, reliable, and useful method for thoracic spine surgery.

摘要

目的

胸椎疾病治疗中的胸椎节段定位比其他脊柱区域更具挑战性。本研究的目的是证明在胸椎手术前计算机断层扫描引导下椎弓根穿刺针置入的可靠性,并减少胸椎和脊髓手术期间的误差范围、手术时间和手术室辐射暴露。

方法

对14例接受胸椎后路手术和/或脊髓相关病变手术的患者进行了研究。在手术当天或前一晚,在CT引导下将棘突针置入相关椎体的椎弓根。按常规准备手术区域,并在CT引导下将棘突针置入相关胸椎椎弓根。

结果

在因各种原因进行的胸椎手术中,接受术前CT引导标记的患者术中节段定位更可靠、更容易。术前准备和术中麻醉时间缩短,术中透视图像数量减少,未观察到脊柱定位错误。

结论

所得结果表明,在所有类型的胸椎手术前用术前CT定位节段是一种安全、可靠且有用的胸椎手术方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbf8/12000984/4df1de101d2d/TJTES-31-371-g001.jpg

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