本文選題：成像　切入點：三維　出處：《中國組織工程研究》2017年03期

【摘要】：背景:隨著近年來更精密的影像學(xué)儀器的出現(xiàn),骨科術(shù)前檢查變得更清晰、準確,借助三維重建技術(shù)勢必能提高椎弓根釘置入的準確性。目的:探討數(shù)字化三維重建技術(shù)輔助胸腰椎椎弓根釘置入的準確性和安全性。方法:收集因脊柱疾病行椎弓根內(nèi)固定的患者200例,隨機分為2組,一組采用傳統(tǒng)解剖標志法結(jié)合術(shù)中透視定位置入椎弓根螺釘(徒手置釘組),一組利用數(shù)字化三維重建技術(shù)輔助置入胸椎椎弓根釘(輔助置釘組)。通過對比虛擬置釘前后的脊柱數(shù)字化模型,記錄完成釘?shù)罍蕚鋾r間、手術(shù)出血量、置釘準確率、椎弓根神經(jīng)血管損傷情況。結(jié)果與結(jié)論:(1)徒手置釘組、輔助置釘組椎弓根螺釘置入準確率分別為85%和99%,兩組一次性置入成功率分別為80%和95%,置釘優(yōu)良率分別為86%和96%,差異無顯著性意義(均P0.05);(2)徒手置釘組完成釘?shù)罍蕚鋾r間為(5.87±1.34)min,置釘出血量為(10.08±7.58)m L;輔助置釘組完成釘?shù)罍蕚鋾r間為(3.91±2.28)min,置釘出血量為(18.31±8.56)m L,兩項指標組間比較差異有顯著性意義(P0.05);(3)徒手置釘組神經(jīng)損傷6例,血管損傷8例;輔助置釘組神經(jīng)損傷0例,血管損傷1例,兩組神經(jīng)、血管損傷情況比較差異有顯著性意義(P0.05);(4)結(jié)果表明,數(shù)字化三維重建技術(shù)輔助胸腰椎椎弓根釘置入的準確性高、置釘安全。
[Abstract]:Background: with the emergence of more sophisticated instruments of imaging in recent years, the Department of orthopedics preoperative examination become more clear, accurate, with 3D reconstruction technology is bound to improve the accuracy of pedicle screw placement. Objective: To investigate the three-dimensional reconstruction of digital technology assisted thoracic and lumbar pedicle screw placement accuracy and safety. Methods: collected by pedicle spinal diseases internal fixation in 200 cases of patients, randomly divided into 2 groups, one group was treated with the traditional anatomical landmarks method combined with fluoroscopy pedicle screws (unarmed nailing group), a group of using three-dimensional reconstruction technology assisted thoracic pedicle screw placement (auxiliary screw group). By comparing the virtual digital model before and after spinal nail record, complete nail tract preparation time, bleeding volume, pedicle screw accuracy, pedicle nerve and blood vessel injury situation. Results and conclusion: (1) unarmed nailing group, pedicle screw placement assisted group. Screw placement accuracy rate were 85% and 99%, the success rate of the two groups were 80% and 95% one-time placement, placement excellent rates were 86% and 96%, there was no significant difference (P0.05); (2) unarmed nailing group completed the preparation time for screw (5.87 + 1.34) min, screw the amount of bleeding was (10.08 + 7.58) m L; auxiliary screw screw group completed the preparation time for (3.91 + 2.28) min, nailing bleeding (18.31 + 8.56) m L, there were significant differences between groups of two indicators (P0.05); (3) free hand pedicle nail in 6 cases group of nerve injury, 8 cases of vascular injury; 0 cases of screw placement assisted group nerve injury, 1 cases of vascular injury, two nerves, there were significant differences of vascular injury (P0.05); (4) the results show that the three-dimensional reconstruction of digital technology assisted thoracic and lumbar pedicle screw placement accuracy of pedicle screws.

【作者單位】： 中山市小欖鎮(zhèn)人民醫(yī)院脊柱創(chuàng)傷骨科;
【基金】：2016年中山市衛(wèi)生和計劃生育局醫(yī)學(xué)科研項目(2016J145)~~
【分類號】：R687.3

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