| 三维CT导航系统辅助下枕颈畸形螺钉置入术 |
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投稿时间：2020-09-15
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| 作者 | Author | 单位 | Address | E-Mail |
| 刘刚 |
LIU Gang |
上海长征医院骨科, 上海 200003 |
Department of Orthopaedics, Changzheng Hospital, Shanghai 200003, China |
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| 田野 |
TIAN Ye |
上海长征医院骨科, 上海 200003 |
Department of Orthopaedics, Changzheng Hospital, Shanghai 200003, China |
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| 曹鹏 |
CAO Peng |
上海长征医院骨科, 上海 200003 |
Department of Orthopaedics, Changzheng Hospital, Shanghai 200003, China |
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| 陈华江 |
CHEN Hua-jiang |
上海长征医院骨科, 上海 200003 |
Department of Orthopaedics, Changzheng Hospital, Shanghai 200003, China |
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| 袁文 |
YUAN Wen |
上海长征医院骨科, 上海 200003 |
Department of Orthopaedics, Changzheng Hospital, Shanghai 200003, China |
yuanwenspine@163.com |
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| 期刊信息：《中国骨伤》2021年，第34卷，第11期，第1029-1033页 |
| DOI：10.12200/j.issn.1003-0034.2021.11.009 |
| 基金项目: |
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中文摘要:
目的：探讨三维CT计算机辅助导航系统辅助下枕颈畸形螺钉置入术中应用的相关问题。
方法：对2015年7月至2018年3月采用外科治疗的61例枕颈畸形患者进行回顾性分析，其中男39例，女22例，年龄25~73（46.20±12.09）岁。根据螺钉置入的不同方式分为导航组（30例）和非导航组（31例），导航组以三维CT计算机辅助导航技术引导螺钉置入，非导航组依据C形臂X线透视及术中解剖标志置入。所有手术由同一手术组人员完成，术后均行CT扫描以评价螺钉位置。
结果：两组共置入螺钉122枚，其中导航组置入60枚，非导航组置入62枚。导航组CT扫描螺钉位置均满意，无螺钉相关并发症。非导航组3枚（4.83%）螺钉位置不满意，术后无明显神经症状。导航组手术时间为87.5~112.5（99.6±12.0）min，非导航组87.5~107.5（97.5±10.5）min，两组差异无统计学意义（P>0.05）。导航组螺钉置入时间1.50~4.20（2.51±1.02）min，非导航组1.80~5.10（3.25±1.05）min，导航组螺钉置入时间短于非导航组（P<0.05）。导航组术中出血量为122~153（137.57±9.48）ml，非导航组为121~158（138.75±8.56）ml，两组差异无统计学意义（P>0.05）。
结论：三维CT计算机辅助导航系统具有成像清晰、定位准确的特点，能有助于提高脊下枕颈畸形手术中置钉的准确性和安全性。 |
| 【关键词】计算机辅助外科手术 脊柱 畸形 |
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| Application of aided three-dimension CT navigation system in craniocervical junction malformation disease surgery |
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ABSTRACT
Objective: To investigate the related problems of three-dimension CT navigation system applied to craniocervical junction malformation diseases surgery.
Methods: The clinical data of 61 patients with craniocervical junction malformation disease who underwent surgical treatment from July 2015 to March 2018 was retrospectively analyzed. There were 39 males and 22 females aged from 25 to 73 years old with a mean of(46.20±12.09) years. According to the different ways of screw placements, these patients were divided into navigation group (30 cases) and non-navigation group (31 cases). The screws insertion in the navigation group were guided under three-dimension CT computer-aided navigation system, while the screws insertion were guided by C-arm fluoroscopy and intraoperative anatomical landmarks in non-navigation group. All surgeries were performed by the same group of surgeons. All cases were scanned by CT after operation to assess the accuracy of the screw insertion.
Results: A total of 122 screws were inserted in the study, including 60 screws in navigation group and 62 screws in non-navigation group. The screw positions in navigation group were all satisfactory, and there were no screw-related complications. The position of 3 screws (4.83%) in non-navigation group was not satisfactory, and there was no obvious neurological symptoms after operation. The operation time of navigation group was from 87.5 to 112.5 min with a mean of(99.6±12.0) min;and non-navigation group was from 87.5 to 107.5 min, with a mean of(97.5±10.5) min. There was no statistically significant difference in the operation time between two groups (P>0.05). The screw insertion time in navigation group was from 1.50 to 4.20 min, with a mean of (2.51±1.02) min;and non-navigation group was from 1.80 to 5.10 min, with a mean of(3.25±1.05) min. The screw insertion time in navigation group was shorter than that in non-navigation group (P<0.05). The intraoperative blood loss in navigation group was from 122 to 153 ml, with a mean of(137.57±9.48) ml, which in non-navigation group was from 121 to 158 ml, with a mean of (138.75±8.56) ml, there was no statistically significant difference between two groups (P>0.05).
Conclusion: The three-dimensional CT computer-aided navigation system has the characteristics of clear imaging and accurate positioning, which can help improve the accuracy and safety of the screw insertion in craniocervical junction malformation disease surgery. |
| KEY WORDS Computer-assisted surgeries Spine Abnormalitiest |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 刘刚,田野,曹鹏,陈华江,袁文.三维CT导航系统辅助下枕颈畸形螺钉置入术[J].中国骨伤,2021,34(11):1029~1033 |
| 英文格式: | LIU Gang,TIAN Ye,CAO Peng,CHEN Hua-jiang,YUAN Wen.Application of aided three-dimension CT navigation system in craniocervical junction malformation disease surgery[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(11):1029~1033 |
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