术中CT导航下颈椎椎弓根螺钉经皮后路置入定位
Intraoperative-CT-navigated percutaneous posterior positioning of pedicle screws in the cervical spine.
作者信息
Stadthalter Holger, Kreinest Michael, Grützner Paul Alfred, Vetter Sven Yves
机构信息
Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Department of Trauma and Orthopaedic Surgery, Krankenhausstr. 12, 91054, Erlangen, Germany.
BG Trauma Center Ludwigshafen, Department of Trauma and Orthopaedic Surgery, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany.
出版信息
Brain Spine. 2025 Jul 24;5:104337. doi: 10.1016/j.bas.2025.104337. eCollection 2025.
INTRODUCTION
This study was conducted to evaluate reliability and precision of a novel intraoperative computed tomography(iCT)-based navigated procedure to minimally invasive positioning of cervical pedicle screws.
METHODS
Ten cases were included. Pedicle screws were positioned percutaneously with iCT-based navigation between C3-C7 (Airo mobile CT scanner, Brainlab, Munich, Germany). In the control CT scan screws were assessed regarding affection of the pedicle cortices and neuroforamina. Image quality was evaluated with a subjective Likert-Scale (0-5) and a semi-objective Assessability score (0-4).
RESULTS
40 screws were placed. Average subjective image quality was 3.57 ± 1.0, average assessability score was 3.59 ± 0.73.23 screws (58 %) were positioned centered in the pedicle. 4 screws perforated the medial wall by more than 2 mm [2.7-2.9]. 9 screws were positioned laterally by more than 2 mm [2.5-4.9]. No postoperative neurological deficits were observed.
CONCLUSION
Even in shallow anatomic structures, iCT-navigated visualization of instruments and implants allows for minimally invasive surgery.
引言
本研究旨在评估一种基于术中计算机断层扫描（iCT）的新型导航程序在颈椎椎弓根螺钉微创定位中的可靠性和精度。
方法
纳入10例患者。使用基于iCT的导航（德国慕尼黑Brainlab公司的Airo移动CT扫描仪）经皮在C3-C7置入椎弓根螺钉。在对照CT扫描中，评估螺钉对椎弓根皮质和神经孔的影响。图像质量采用主观李克特量表（0-5）和半客观可评估性评分（0-4）进行评估。
结果
共置入40枚螺钉。主观图像质量平均为3.57±1.0，可评估性评分平均为3.59±0.73。23枚螺钉（58%）位于椎弓根中心。4枚螺钉穿破内侧壁超过2mm[2.7-2.9]。9枚螺钉位于外侧超过2mm[2.5-4.9]。未观察到术后神经功能缺损。
结论
即使在解剖结构较浅的情况下，基于iCT导航的器械和植入物可视化也能实现微创手术。
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