Positioning Thoracic Pedicle Screw Entry Point Using a New Landmark A Study Based on 3-Dimensional Computed Tomographic Scan
Positioning Thoracic Pedicle Screw Entry Point Using a New Landmark A Study Based on 3-Dimensional Computed Tomographic Scan
复制标题
使用新地标定位胸椎椎弓根螺钉进入点基于 3 维计算机断层扫描的研究
DOI：
10.1097/brs.0000000000000398
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发表时间：
2014-07-15
期刊：
影响因子：
3
通讯作者：
Wang, Yan
中科院分区：
文献类型：
--
作者：
Qi, Deng-bin;Wang, Jing-ming;Wang, Yan
研究设计。一种识别入口点的新颖方法。目的。量化正常受试者和青少年特发性脊柱侧凸患者胸椎各节段椎板上胸椎弓根螺钉进入点的位置，并提出一种使用新标志来选择进入点的新技术。背景数据摘要。胸椎椎弓根螺钉已广泛应用于胸外科，椎弓根螺钉的置入也得到了广泛的研究。但对于切入点的选择只有定性研究，尚无研究对切入点的位置进行量化的方法。采用三维计算机断层扫描重建技术的回顾性研究，对 110 名青少年（56 例青少年特发性脊柱侧凸和 54 名正常受试者）的胸椎形态进行了研究。使用定量区域来选择切入点。使用新标志作为参考确定胸椎椎弓根螺钉进入点，并为 21 名患者放置了胸椎椎弓根螺钉。进行术后计算机断层扫描以评估这种切入点选择技术的安全性和有效性。结果。我们确定，使用定量面积定位进入点后的椎弓根螺钉置入精度明显优于使用传统方法定位进入点后的置入精度（P < 0.05）。结论。新技术量化了每个胸椎椎弓根螺钉进入点的位置，方便、易操作，螺钉置入精度较高。该定位技术可为临床选择胸椎椎弓根螺钉入钉点提供安全、准确的指导。
Study Design. A novel method to identify the entry point.Objective. To quantify the position of thoracic pedicle screw entry points on the lamina at various segments of the thoracic vertebrae in normal subjects and patients with adolescent idiopathic scoliosis and propose a new technique to select entry points using a new landmark.Summary of Background Data. Thoracic pedicle screws have been widely used in thoracic surgery, and the placement of pedicle screws has been studied extensively. However, there are only qualitative studies on selecting the entry point, and no study has quantified the position of entry points.Methods. A retrospective study using 3-dimensional computed tomographic reconstruction techniques were used to study the morphology of thoracic vertebrae in 110 adolescents (56 cases of adolescent idiopathic scoliosis and 54 normal subjects). A quantitative area was used to select the entry point. Thoracic pedicle screw entry point was determined using the new landmark as reference and thoracic pedicle screws were placed in 21 patients. Postoperative computed tomographic scanning was performed to assess the safety and effectiveness of this entry point selection technique.Results. We determined that the accuracy of pedicle screw placing after positioning entry point using the quantitative area was significantly superior to that after positioning entry point using the traditional method (P < 0.05).Conclusion. The new technique quantifies the position of each thoracic pedicle screw entry point and it is convenient, easy to operate, and has relatively high accuracy of screw placement. This positioning technique can provide safe and accurate clinical guidance for selecting thoracic pedicle screw entry point.