Iso-C3D navigation assisted pedicle screw placement in deformities of the cervical and thoracic spine.
Iso-C3D navigation assisted pedicle screw placement in deformities of the cervical and thoracic spine.
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DOI：
10.4103/0019-5413.62083
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发表时间：
2010-04
影响因子：
1
通讯作者：
Rajasekaran S
中科院分区：
文献类型：
--
作者：
V Rajan V;Kamath V;Shetty AP;Rajasekaran S
即使对于最有经验的外科医生来说，对变形的颈椎和胸椎进行椎弓根螺钉固定也是一项挑战，并且与螺钉错位的发生率增加有关。据报道，基于 Iso-C3D 的导航可以提高椎弓根螺钉放置的准确性，但是，很少有研究评估其在存在畸形的情况下的功效。我们进行了一项研究，以评估基于 Iso-C3D 的导航在变形颈椎和胸椎椎弓根螺钉固定中的准确性。我们使用基于 Iso-C3D 的导航插入 98 个颈椎椎弓根螺钉（18 名患者）和 242 个胸椎椎弓根螺钉（17 名患者），以治疗因脊柱侧凸、强直性脊柱炎、创伤后和退行性疾病导致的脊柱畸形。两名独立观察员根据术后计算机断层扫描 (CT) 扫描确定螺钉置入的准确性并对其进行分级。术后颈椎 CT 扫描显示，90.8% 的螺钉放置完好，其中有 7 例（7%）I 级椎弓根破裂、2 例（2%）II 级椎弓根破裂和 1 例前皮质穿透（< 2mm）。外侧椎弓根裂口5处侵犯椎动脉孔，内侧椎弓根裂口3处侵入椎管；然而，没有患者出现任何神经血管并发症。在胸椎中，92.2% 的螺钉放置完美，只有 6 个 (2%) II 级椎弓根破损、8 个 (3%) I 级椎弓根破损和 5 个螺钉 (2%) 穿透前皮质或外侧皮质。没有遇到神经血管并发症。基于 Iso-C3D 的导航提高了颈椎和胸椎畸形中椎弓根螺钉放置的准确性。椎弓根破裂发生率低意味着患者的安全性更高。
Pedicle screw instrumentation of the deformed cervical and thoracic spine is challenging to even the most experienced surgeon and associated with increased incidence of screw misplacement. Iso-C3D based navigation has been reported to improve the accuracy of pedicle screw placement, however, there are very few studies assessing its efficacy in the presence of deformity. We conducted a study to evaluate the accuracy of Iso-C3D based navigation in pedicle screw fixation in the deformed cervical and thoracic spine. We inserted 98 cervical pedicle screws (18 patients) and 242 thoracic pedicle screws (17 patients) using Iso-C3D based navigation for deformities of spine due to scoliosis, ankylosing spondylitis, post traumatic and degenerative disorders. Two independent observers determined and graded the accuracy of screw placement from postoperative computed tomography (CT) scans. Postoperative CT scans of the cervical spine showed 90.8% perfectly placed screws with 7 (7%) grade I pedicle breaches, 2 (2%) grade II pedicle breaches and one anterior cortex penetration (< 2mm). Five lateral pedicle breaches violated the vertebral artery foramen and three medial pedicle breaches penetrated the spinal canal; however, no patient had any neurovascular complications. In the thoracic spine there were 92.2% perfectly placed screws with only six (2%) grade II pedicle breaches, eight (3%) grade I pedicle breaches and five screws (2%) penetrating the anterior or lateral cortex. No neuro-vascular complications were encountered. Iso-C3D based navigation improves the accuracy of pedicle screw placement in deformities of the cervical and thoracic spine. The low incidence of pedicle breach implies increased safety for the patient.
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DOI：
10.1007/bf01676569
发表时间：
1997-01-01
期刊：
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
影响因子：
--
作者：
Boos, N;Webb, J K
通讯作者：
Webb, J K
影响因子：
3
作者：
Ludwig, SC;Kowalski, JM;Heller, JG
通讯作者：
Heller, JG
影响因子：
3
作者：
Liljenqvist, UR;Link, TM;Halm, HFH
通讯作者：
Halm, HFH
影响因子：
3
作者：
Liljenqvist, UR;Halm, HFH;Link, TM
通讯作者：
Link, TM
影响因子：
3
作者：
Abumi, K;Shono, Y;Kaneda, K
通讯作者：
Kaneda, K