三维平板透视引导脊柱椎弓根螺钉置入的准确性研究

发布时间：2018-01-01 08:24

本文关键词：三维平板透视引导脊柱椎弓根螺钉置入的准确性研究　出处：《蚌埠医学院》2016年硕士论文　论文类型：学位论文

【摘要】：目的:探讨分析三维平板透视定位系统在脊柱椎弓根螺钉内固定术中辅助置钉的准确性及实用性。方法:将2011-01~2013-10收治的206例接受脊柱椎弓根螺钉内固定术的患者作为研究对象,根据术中透视定位设备的不同,将研究对象分为对照组和实验组。对照组为2011-01~2012-05收治的95例患者(术中透视设备为普通C型臂X线机),男性59例,女性36例,年龄17-74岁,平均46岁,颈椎8例,胸椎12例,腰骶椎75例;实验组为2012-06~2013-10收治的111例患者(术中透视设备为三维平板透视设备),男性62例,女性49例,年龄19-79岁,平均48岁,颈椎11例,胸椎5例,腰骶椎95例。通过分析术后复查X线及CT,收集并比较两组术后椎弓根螺钉在位情况,并将数据进行统计学分析。结果:本组206例研究对象共置入椎弓根螺钉916枚,实验组492枚,对照组424枚,长度18~50mm。实验组螺钉位置优占43.7%,良占53.9%,差占2.4%;对照组螺钉位置优占26.9%,良占67.2%,差占5.9%。术后193例患者获得随访,13例失访,失访原因为患者所留联系方式失效及未遵医嘱定期复查等,随访6~24个月,平均14个月。对照组中有2例螺钉位置差的患者出现术后严重并发症,下肢功能恢复不佳,实验组、对照组均无钉、棒的断裂及脱落现象。结论:三维平板透视定位系统在脊柱椎弓根螺钉内固定术中的置钉准确性高于普通的移动C型臂X线机。而且,相对于近年来应用在临床上的其他较先进的术中透视导航设备,还具有经济适用、操作简单,学习曲线短等优点,适合在国内推广使用。
[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.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R687.3

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