3D导航联合神经监护在寰枢椎手术中的应用

发布时间：2018-08-10 17:54

【摘要】：目的探讨术中3D导航联合神经监护在寰枢椎手术中的应用价值。方法回顾分析接受寰枢椎后路椎弓根螺钉内固定手术且符合筛选标准的74例患者的临床资料,根据手术方案分组,其中透视组22例,导航组24例,导航联合监护组28例。通过对比3组患者术前术后JOA评分、NDI评分、手术时长、平均置钉时间、一级螺钉比例、术后并发症情况,分析3组患者临床疗效,置钉准确性及安全性等情况。结果导航联合监护组及导航组置钉准确率显著高于透视组,差异有统计学意义(P0.05);术后3个月JOA评分及JOA评分改善率导航联合监护组高于另外两组(P0.05),而NDI评分、平均置钉时间、术后并发症3组患者差异无统计学意义(P0.05)。结论导航联合神经监护辅助寰枢椎手术能改善患者术后功能,增加手术安全性,提高手术疗效,同时能提高置钉准确率,并且不会延长置钉时间。
[Abstract]:Objective to evaluate the value of 3 D navigation combined with nerve monitoring in atlantoaxial surgery. Methods the clinical data of 74 patients with posterior atlantoaxial pedicle screw fixation were retrospectively analyzed. According to the operation plan, there were 22 cases in the fluoroscopy group, 24 cases in the navigation group and 28 cases in the combined navigation group. The clinical efficacy, accuracy and safety of the three groups of patients were analyzed by comparing the preoperative and postoperative JOA scores, the duration of operation, the average time of nail placement, the ratio of first-grade screws, the postoperative complications and so on. Results the accuracy of nail placement in navigation joint monitoring group and navigation group was significantly higher than that in fluoroscopy group (P0.05), the improvement rate of JOA score and JOA score in navigation joint monitoring group was higher than that in the other two groups (P0.05), but the NDI score and the mean nail placement time were higher in the navigation joint monitoring group than in the other two groups (P0.05). There was no significant difference in postoperative complications among the three groups (P0.05). Conclusion Anatlantoaxial surgery assisted by navigation and nerve monitoring can improve the postoperative function, increase the safety of the operation, improve the curative effect, and improve the accuracy of nail placement without prolonging the nail placement time.
【作者单位】：广州医科大学附属第二医院骨外科;
【基金】：广东省科技计划项目(编号:2014A020212510)
【分类号】：R687.3

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