文档介绍：导航辅助置入下颈椎椎弓根螺钉的误差分析
作者:张洪磊,周东生,王大伟
【摘要】目的探讨导航辅助置入下颈椎椎弓根螺钉的准确性和产生误差的原因。[方法]25例下颈椎疾患手术病人,导航辅助下置入144枚颈椎(C3~7)椎弓根螺钉,术后行X线、CT检查,横断位测量螺钉中线与椎弓根内壁的相对位置、与椎体中线的角度;矢状位测量螺钉中线与椎弓根上壁的相对位置、与椎体上缘的角度;并与导航图像的对应数据进行统计学分析。[结果]2枚螺钉穿出椎弓根上壁,3枚螺钉穿出椎弓根外壁入椎动脉孔,其它螺钉术后CT和术中导航图像所显示的位置角度无显著性差异,导航图像的显示是基于坚硬物体原则,颈椎手术本身特点不可能完全满足如此要求,两者偏差表现为“漂移”现象。[结论]导航辅助置入下颈椎椎弓根螺钉准确性显著提高,术中漂移是置钉偏差的原因。
【关键词】计算机辅助导航颈椎椎弓根螺钉
Abstract:[Objective]To evaluate the accuracy puterassisted cervical pedicle screw installation and discuss the reasons of screw malposition.[Method]Totally 144 cervical pedicle screws were installed puterassisted navigation in 25 patients with lower cervical spinal the patients were examined by Xrays and CT after position and direction were measured on the sagittal and transsection image of intraoperative navigation and post
operative result was analyzed statistically.[Result]Two screws perforated the upper pedicle wall,3 deviated from the lateral pedicle was no statistical difference in screw position or direction between navigation and CT images were based on the principle of rigid tissue.[puterassisted navigation can improve the accuracy of cervical pedicle screw malposition is responsible for the excursion phenomenon.
Key puterassisted navigation; cervical spine; pedicle screw
导航系统在腰椎椎弓根螺钉固定中已被应用[1]。颈椎椎弓