[1]都金鹏 黄大耿△ 郝定均 赵勤鹏 黄研生 赵赫 王晓辉 张嘉男 杨俊松.脊柱外科三种导航技术辅助椎弓根螺钉植入精确度的比较[J].中国中医骨伤科杂志,2019,27(12):13-17.
　DU Jinpeng HUANG Dageng HAO Dingjun ZHAO Qinpeng HUANG Yansheng ZHAO He WANG Xiaohui ZHANG Jianan YANG Junsong.Accuracy of Pedicle Screw Insertion among 3 Assisted Technologies in Spine Surgery[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2019,27(12):13-17.
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脊柱外科三种导航技术辅助椎弓根螺钉植入精确度的比较()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第27卷
期数:
2019年12期
页码:
13-17
栏目:
临床研究
出版日期:
2019-12-04

文章信息/Info

Title:
Accuracy of Pedicle Screw Insertion among 3 Assisted Technologies in Spine Surgery
文章编号:
1005-0205(2019)12-0013-05
作者:
都金鹏1 黄大耿1△ 郝定均1 赵勤鹏1 黄研生1 赵赫1 王晓辉1 张嘉男1 杨俊松1
1西安交通大学附属红会医院脊柱外科(西安, 710054)
Author(s):
DU Jinpeng1 HUANG Dageng1 HAO Dingjun1 ZHAO Qinpeng1 HUANG Yansheng1 ZHAO He1 WANG Xiaohui1 ZHANG Jianan1 YANG Junsong1
1Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, China.
关键词:
机器人导航;  导航模板;  O-臂导航系统;  椎弓根螺钉
Keywords:
robotic-assisted;  navigation template;  O-arm-based navigation system;  pedicle screw
分类号:
R681.5
文献标志码:
A
摘要:
目的:分析脊柱机器人与其他导航工具在治疗腰椎退行性疾病时辅助椎弓根螺钉植入的精确度差异。方法:使用脊柱机器人(第1组)对39名患者植入176枚椎弓根螺钉,使用导航模板(第2组)在28例患者中植入134枚螺钉,51例患者通过O-臂导航植入234枚螺钉(第3组)。应用术后CT扫描并根据Rampersaud A～D分级评估螺钉植入的精确度, 同时收集其他临床资料。结果:“完美”椎弓根螺钉植入(A级),1～3组精确度分别为90.34%,91.79%,84.19%. “临床可接受”螺钉植入(A级+B级),1～3组精确度分别为94.32%,95.52%, 90.60%.矢状位偏移角度分别为3.14°±9.28°,2.33°±10.38°,4.40°±7.25°; 横断位偏移角度分别为3.26°±8.21°,3.39°±7.00°,4.10°±9.02°.统计分析显示,第1组与第2组、第3组分别相比,其“完美和临床可接受”以及矢状位、横断位偏移精确度差异无统计学意义(P<0.05)。结论:机器人引导技术相比于导航模板或O-臂导航系统,在辅助螺钉植入时并未显示出明显的精确度差异,但其显著减少了不良事件发生率及术中失血量。
Abstract:
Objective:To study the difference of accuracy of pedicle screw insertion between spine robot and other two assisted tools for the treatment of lumbar degenerative disease. Methods: A total of 176 pedicle screws were inserted in 39 patients using spine robot(group 1), 134 screws were implanted in 28 patients using navigational template(group 2), 234 screws in 51 patients by O-arm-based navigation(group 3). The screw position was evaluated using postoperative CT scans according to Rampersaud A～D classification. Other secondary datas have been collected too. Results:“Perfect” pedicle screw insertion(Grade A)with the accuracy of 90.34%, 91.79% and 84.19% were revealed respectively in the group 1～3. “Clinically acceptable” screw implantation(Grade A+B)with the accuracy of 94.32%, 95.52% and 90.60% were revealed respectively in the group 1～3. Sagittal offset angles were 3.14°±9.28°,2.33°±10.38°, and 4.40°±7.25°. Transversal offset angles were 3.26°±8.21°,3.39°±7.00° and 4.10°±9.02°. No statistically significant difference was found between1 group and other two groups in the accuracy of “Perfect and Clinical acceptable” as well as sagittal or transversal offset(P<0.05). Conclusion:Robotic-assistance technology seem not to shows high-accuracy than navigation template or O-arm system for screw implantation, but it significantly reduced adverse events, postoperative stay and blood loss.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目:陕西省重点研发计划(2019SF-213) 西安交通大学基本科研业务费自由探索与创新- 教师类项目(xzy0120199130) 陕西省卫生健康科研基金项目(2018E002)△通信作者 E-mail:345070558@qq.com(收稿日期:2019-10-12)
更新日期/Last Update: 2019-12-04