摘要
[目的]探讨采用术中三维影像脊柱导航技术引导的椎体成形术治疗骨质疏松性椎体压缩骨折的方法和效果。[方法]41例骨质疏松性椎体压缩骨折患者分别采用术中三维影像脊柱导航(A组)和传统C型臂X线机透视(B组)引导完成椎体成形术。两组分别配对比较手术前后RDQ评分及VAS评分变化,分组比较两组间患者平均手术时间、透视次数、椎弓根穿刺精确度,术后复查X线片了解骨水泥分布情况。[结果]共46椎成功注射骨水泥,所有患者手术前后RDQ评分及VAS评分均有显著差异,组间差异不明显。A组平均手术时间及透视次数明显低于B组。A组未发现椎弓根穿破病例,B组有1例椎体发生骨水泥渗漏于椎旁软组织,但椎管及椎弓根结构完整。术后平均随访21个月(6～38个月),无明显并发症,无椎体塌陷。[结论]采用术中三维影像脊柱导航引导行椎体成形术,能明显提高手术精确度和安全性,并能缩短手术时间,减少透视次数,减少手术并发症,疗效肯定。
[ Objective] To study the effect of intra-operative three-dimensional fluoroscopy-based spinal navigation guidance for vertebroplasty to treat osteoporotic vertebral compression fracture（OVCF）. [ Method] A clinical study was performed in which 41 patients suffering painful osteoporotic vertebral compression fractures underwent vertebroplasty procedure. During this proce- dure, cannulation of the pedicle and vertebral body was performed with the aid of isocentric 3D fluoroscopy-based spinal navigation （ group A） and biplanar fluoroscopy （ group B）. RDQ and VAS of each group was compared between preoperation and postopera- tion. Total operating time, intra-operative fluoroscopy time and pedicle puncturation accuracy were compared between group A and group B. Possible complications such as cement extravasations were evaluated with X-ray fluoroscopy. [ Result] Forty-six vertebrae were successfully injected with polymethyl methaerylate. The two groups had statistically significant difference in RDQ and VAS between preoperation and postoperation, but no statistically significant difference between the two groups. Mean operating time and intra-operative fluoroscopy times of group A were shorter than those in group B. There was no case of broken pedic]e in group A. One vertebra was found to have bone cement leakage to soft tissue in group B, but the vertebral canal and pedicle intact. The au- thor followed up for an average of 21 months （range 8 -38 months） and found no severe complication or collapse of vertebra. [ Conclusion] With the aid of intra-operative three-dimensional fluoroscopy-based spinal navigation, vertebroplasty can be per- formed more accuractly and securely. The shorter total operating time, intra-operative fluoroscopy times are convincing and less possible complication can be expected.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2009年第12期891-894,共4页
Orthopedic Journal of China
关键词
导航
椎体成形术
椎体压缩骨折
navigation
vertebroplasty
vertebral compression fracture
