EVALUATION OF TWO-DIMENSION COMPUTER-AIDED SURGERY NAVIGATION SYSTEM FOR LUMBAR PEDICLE SCREW FIXATION ON RECOMBINANT CT SECTION AFTER OPERATION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WUChao ,  TANLun , LINXu , HUHaigang

Department of Orthopedics, the Fourth People's Hospital of Zigong City, Zigong Sichuan, 643000, P. R. China;

Corresponding author：

TANLun, Email: flightiness@163.com

Keywords：

Computer-aided surgery navigation system; Lumbar vertebrae; Internal fixators

DOI：

10.7507/1002-1892.20150098

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the accuracy of the two-dimension computer-aided surgery navigation system in the lumbar pedicle screw fixation on recombinant CT section after operation. Methods Between February 2011 and April 2013, 218 patients undergoing lumbar spinal pedicle screw fixation were divided into 2 groups:two-dimension computer-aided surgery navigation system was used in 95 cases (the navigation group) and X-ray fluoroscopy assistant technology in 123 cases (the fluoroscopy assistant group). There was no significant difference in age, gender, and type of disease between 2 groups (P>0.05). The mean operating time, blood loss volume, and fluoroscopy times, and the one-time success rate of pedicle screw implant were observed. The sagittal screw angle (SSA), the relationship between the pedicle cortex and screw, the accuracy rate of pedicle screw, and the sagittal angle on both sides (SBA) were observed. Results A total of 504 screws were inserted in navigation group, 432 (85.7%) were inserted successfully at first time and 472 (85.7%) were inserted successfully at end time. A total of 656 screws were inserted in fluoroscopy assistant group, 474 (72.3%) were successfully inserted at first time, and 563 (85.8%) were inserted successfully at end time. There were significant differences in the one-time success rate and final success rate of pedicle screw implant between 2 groups (χ²=30.19, P=0.00; χ²=18.16, P=0.00). There was no significant difference in the mean operating time and the blood loss volume of pedicle screw implant between 2 groups (t=0.88, P=0.38; t=1.47, P=0.14); but the fluoroscopy times of pedicle screw implant in navigation group 0.7±0.3 were significantly less than that in fluoroscopy assistant group 1.5±1.0 (t=-8.09, P=0.00). The SSA and SBA in navigation group[(3.7±0.9)° and (1.7±0.8)°] were significantly less than those in fluoroscopy assistant group[(6.0±1.7)° and (3.5±1.6)°] (t=-26.92, P=0.00; t=-22.49, P=0.00). Conclusion The sagittal screw angle and accuracy of pedicle screw implant can be significantly improved using the two-dimension computer-aided surgery navigation system in lumbar posterior fixation.

Citation： WUChao, TANLun, LINXu, HUHaigang. EVALUATION OF TWO-DIMENSION COMPUTER-AIDED SURGERY NAVIGATION SYSTEM FOR LUMBAR PEDICLE SCREW FIXATION ON RECOMBINANT CT SECTION AFTER OPERATION. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(4): 452-456. doi: 10.7507/1002-1892.20150098 Copy

1.	张超, 孙天威, 田融, 等. 两种手术方式治疗峡部裂型腰椎滑脱症的对比研究. 中国修复重建外科杂志, 2015, 29(2):179-183.
2.	李鹏飞, 贾楠, 靳宪辉, 等. 椎间植骨粒体积对腰椎后路滑脱复位植骨融合内固定术后融合效果的影响. 中国修复重建外科杂志, 2013, 27(6):696-702.
3.	龚全, 孔清泉, 李涛, 等. 后路复位技术在重度腰椎滑脱症治疗中的应用. 中国修复重建外科杂志, 2013, 27(4):393-398.
4.	高明暄, 李旭升, 甄平, 等. 膨胀螺钉及钉道强化在骨质疏松椎体中的力学可靠性研究. 中华创伤骨科杂志, 2014, 16(6):521-526.
5.	Laine T, Lund T, Ylikoski M, et al. Accuracy of pedicle screw insertion with and without computer assistance:a randomized controlled clinical study in 100 consecutive patients. Eur Spine J, 2000, 9(3):235-240.
6.	刘延青, 刘岩, 张克, 等. 导航辅助腰椎椎弓根螺钉置入的误差分析. 中国脊柱脊髓杂志, 2005, 15(12):736-739.
7.	宋永兴, 曾忠友. 胸腰椎椎弓根螺钉置钉技术关键及其并发症的预防. 中国矫形外科杂志, 2012, 20(14):1306-1308.
8.	殷海东, 黄明光, 黄东生, 等. 个体化选择脊柱侧凸患者胸椎椎弓根螺钉进钉点的研究. 中国脊柱脊髓杂志, 2009, 19(3):193-197.
9.	Steinmann JC, Herkowitz HN, el-Kommons H, et a1. Spinal pedicle fixation. Confirmation of all image-based technique for screw placement. Spine (Phila Pa 1976), 1993, 18(13):1856-1861.
10.	孙麟, 宋跃明, 龚全, 等. 实时三维导航技术应用于先天性脊柱侧凸矫形的近期疗效. 中国修复重建外科杂志, 2013, 27(2):129-134.
11.	Foley KT, Simon DA, Rampersaud YR. Virtual fluoroscopy:computer-assisted fluoroscopic navigation. Spine (Phila Pa 1976), 2001, 26(4):347-351.
12.	王黎明, 喻忠, 桂鉴超, 等. 计算机导航辅助下经皮椎体成形术. 中华骨科杂志, 2006, 10(26):676-681.
13.	谭伦, 吴超, 罗晓中, 等. 以椎板边缘对腰椎椎弓根螺钉进钉点的个体化定位. 中国矫形外科杂志, 2008, 16(3):207-210.
14.	冯海龙, 陈隆益, 谭海斌, 等. 计算机导航辅助椎弓根螺钉固定的临床研究. 中华神经外科杂志, 2007, 23(5):332-335.
15.	田伟, 刘亚军, 刘波, 等. 计算机导航在脊柱外科手术应用实验和临床研究. 中华骨科杂志, 2006, 26(10):671-675.
16.	Richter M, Mattes T, Cakir B. Computer-assisted posterior instrumentation of the cervical and cervico-thoracic spine. Eur Spine J, 2004, 13(1):50-59.
17.	张良, 徐宏兵, 王英民, 等. 二维计算机辅助手术导航对双侧腰椎椎弓根螺钉植入一致性的影响. 中华骨科杂志, 2013, 33(12):1190-1195.
18.	Weinstein JN, Rydevik BL, Orausching WR, et al. Anatomical and technical considerations of pediele screw fixation. Clin Orthop Relat Res, 1992, (284):34-36.
19.	杨曦, 孔清泉, 宋跃明, 等. 计算机导航辅助椎弓根螺钉后路固定在骨质疏松患者中的临床应用. 中国修复重建外科杂志, 2012, 26(2):196-200.
20.	吴超, 谭伦, 林旭, 等. 矢状曲度参考模棒在胸腰椎骨折手术中的临床应用. 中国脊柱脊髓杂志, 2013, 23(10):898-904.

1. 张超, 孙天威, 田融, 等. 两种手术方式治疗峡部裂型腰椎滑脱症的对比研究. 中国修复重建外科杂志, 2015, 29(2):179-183.
2. 李鹏飞, 贾楠, 靳宪辉, 等. 椎间植骨粒体积对腰椎后路滑脱复位植骨融合内固定术后融合效果的影响. 中国修复重建外科杂志, 2013, 27(6):696-702.
3. 龚全, 孔清泉, 李涛, 等. 后路复位技术在重度腰椎滑脱症治疗中的应用. 中国修复重建外科杂志, 2013, 27(4):393-398.
4. 高明暄, 李旭升, 甄平, 等. 膨胀螺钉及钉道强化在骨质疏松椎体中的力学可靠性研究. 中华创伤骨科杂志, 2014, 16(6):521-526.
5. Laine T, Lund T, Ylikoski M, et al. Accuracy of pedicle screw insertion with and without computer assistance:a randomized controlled clinical study in 100 consecutive patients. Eur Spine J, 2000, 9(3):235-240.
6. 刘延青, 刘岩, 张克, 等. 导航辅助腰椎椎弓根螺钉置入的误差分析. 中国脊柱脊髓杂志, 2005, 15(12):736-739.
7. 宋永兴, 曾忠友. 胸腰椎椎弓根螺钉置钉技术关键及其并发症的预防. 中国矫形外科杂志, 2012, 20(14):1306-1308.
8. 殷海东, 黄明光, 黄东生, 等. 个体化选择脊柱侧凸患者胸椎椎弓根螺钉进钉点的研究. 中国脊柱脊髓杂志, 2009, 19(3):193-197.
9. Steinmann JC, Herkowitz HN, el-Kommons H, et a1. Spinal pedicle fixation. Confirmation of all image-based technique for screw placement. Spine (Phila Pa 1976), 1993, 18(13):1856-1861.
10. 孙麟, 宋跃明, 龚全, 等. 实时三维导航技术应用于先天性脊柱侧凸矫形的近期疗效. 中国修复重建外科杂志, 2013, 27(2):129-134.
11. Foley KT, Simon DA, Rampersaud YR. Virtual fluoroscopy:computer-assisted fluoroscopic navigation. Spine (Phila Pa 1976), 2001, 26(4):347-351.
12. 王黎明, 喻忠, 桂鉴超, 等. 计算机导航辅助下经皮椎体成形术. 中华骨科杂志, 2006, 10(26):676-681.
13. 谭伦, 吴超, 罗晓中, 等. 以椎板边缘对腰椎椎弓根螺钉进钉点的个体化定位. 中国矫形外科杂志, 2008, 16(3):207-210.
14. 冯海龙, 陈隆益, 谭海斌, 等. 计算机导航辅助椎弓根螺钉固定的临床研究. 中华神经外科杂志, 2007, 23(5):332-335.
15. 田伟, 刘亚军, 刘波, 等. 计算机导航在脊柱外科手术应用实验和临床研究. 中华骨科杂志, 2006, 26(10):671-675.
16. Richter M, Mattes T, Cakir B. Computer-assisted posterior instrumentation of the cervical and cervico-thoracic spine. Eur Spine J, 2004, 13(1):50-59.
17. 张良, 徐宏兵, 王英民, 等. 二维计算机辅助手术导航对双侧腰椎椎弓根螺钉植入一致性的影响. 中华骨科杂志, 2013, 33(12):1190-1195.
18. Weinstein JN, Rydevik BL, Orausching WR, et al. Anatomical and technical considerations of pediele screw fixation. Clin Orthop Relat Res, 1992, (284):34-36.
19. 杨曦, 孔清泉, 宋跃明, 等. 计算机导航辅助椎弓根螺钉后路固定在骨质疏松患者中的临床应用. 中国修复重建外科杂志, 2012, 26(2):196-200.
20. 吴超, 谭伦, 林旭, 等. 矢状曲度参考模棒在胸腰椎骨折手术中的临床应用. 中国脊柱脊髓杂志, 2013, 23(10):898-904.

Chinese Journal of Reparative and Reconstructive Surgery

EVALUATION OF TWO-DIMENSION COMPUTER-AIDED SURGERY NAVIGATION SYSTEM FOR LUMBAR PEDICLE SCREW FIXATION ON RECOMBINANT CT SECTION AFTER OPERATION

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content