本文關(guān)鍵詞：三維平板透視引導(dǎo)脊柱椎弓根螺釘置入的準(zhǔn)確性研究　出處：《蚌埠醫(yī)學(xué)院》2016年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 椎弓根螺釘 三維平板透視 術(shù)中定位

【摘要】：目的:探討分析三維平板透視定位系統(tǒng)在脊柱椎弓根螺釘內(nèi)固定術(shù)中輔助置釘?shù)臏?zhǔn)確性及實(shí)用性。方法:將2011-01~2013-10收治的206例接受脊柱椎弓根螺釘內(nèi)固定術(shù)的患者作為研究對(duì)象,根據(jù)術(shù)中透視定位設(shè)備的不同,將研究對(duì)象分為對(duì)照組和實(shí)驗(yàn)組。對(duì)照組為2011-01~2012-05收治的95例患者(術(shù)中透視設(shè)備為普通C型臂X線(xiàn)機(jī)),男性59例,女性36例,年齡17-74歲,平均46歲,頸椎8例,胸椎12例,腰骶椎75例;實(shí)驗(yàn)組為2012-06~2013-10收治的111例患者(術(shù)中透視設(shè)備為三維平板透視設(shè)備),男性62例,女性49例,年齡19-79歲,平均48歲,頸椎11例,胸椎5例,腰骶椎95例。通過(guò)分析術(shù)后復(fù)查X線(xiàn)及CT,收集并比較兩組術(shù)后椎弓根螺釘在位情況,并將數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:本組206例研究對(duì)象共置入椎弓根螺釘916枚,實(shí)驗(yàn)組492枚,對(duì)照組424枚,長(zhǎng)度18~50mm。實(shí)驗(yàn)組螺釘位置優(yōu)占43.7%,良占53.9%,差占2.4%;對(duì)照組螺釘位置優(yōu)占26.9%,良占67.2%,差占5.9%。術(shù)后193例患者獲得隨訪(fǎng),13例失訪(fǎng),失訪(fǎng)原因?yàn)榛颊咚袈?lián)系方式失效及未遵醫(yī)囑定期復(fù)查等,隨訪(fǎng)6~24個(gè)月,平均14個(gè)月。對(duì)照組中有2例螺釘位置差的患者出現(xiàn)術(shù)后嚴(yán)重并發(fā)癥,下肢功能恢復(fù)不佳,實(shí)驗(yàn)組、對(duì)照組均無(wú)釘、棒的斷裂及脫落現(xiàn)象。結(jié)論:三維平板透視定位系統(tǒng)在脊柱椎弓根螺釘內(nèi)固定術(shù)中的置釘準(zhǔn)確性高于普通的移動(dòng)C型臂X線(xiàn)機(jī)。而且,相對(duì)于近年來(lái)應(yīng)用在臨床上的其他較先進(jìn)的術(shù)中透視導(dǎo)航設(shè)備,還具有經(jīng)濟(jì)適用、操作簡(jiǎn)單,學(xué)習(xí)曲線(xiàn)短等優(yōu)點(diǎn),適合在國(guó)內(nèi)推廣使用。
[Abstract]:Objective: to investigate the accuracy and practicability of three-dimensional flat plate fluoroscopic positioning system in pedicle screw fixation. A total of 206 patients with spinal pedicle screw internal fixation were enrolled in the study in 2011-01 and 2013-10. According to the intraoperative fluoroscopy location equipment. The subjects were divided into control group and experimental group. The control group consisted of 95 patients treated in 2011-01 and 2012-05. There were 36 females aged 17-74 years (mean 46 years), 8 cervical vertebrae, 12 thoracic vertebrae and 75 lumbosacral vertebrae. The experimental group consisted of 111 patients (62 males and 49 females aged 19-79 years) who were admitted to the hospital in 2013-10 (62 males and 49 females). The average age was 48 years, cervical vertebrae 11 cases, thoracic vertebra 5 cases, lumbosacral 95 cases. Results: totally 916 pedicle screws were implanted in 206 cases, 492 were in the experimental group and 424 in the control group. The position of the screws in the experimental group was 43.7mm, 53.9% in the good group and 2.4% in the poor group. The control group had excellent screw position (26.9%), good (67.2%) and poor (5.9%). The reasons for the loss of visit were the failure of the contact mode and the failure to follow up regularly according to the doctor's instructions. The follow-up period ranged from 6 to 24 months, with an average of 14 months. In the control group, 2 patients with poor screw position had serious postoperative complications. The lower extremity function was not recovered well, the experimental group and the control group had no nail. Conclusion: the accuracy of screw placement in pedicle screw fixation is higher than that in normal C-arm X-ray machine. Compared with other advanced intraoperative fluoroscopic navigation equipment which has been applied in clinic in recent years, it has the advantages of economical application, simple operation, short learning curve, and so on. It is suitable for popularizing and using in China.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R687.3

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