O-arm三维计算机导航系统引导下置钉修复严重脊柱畸形的安全性.doc.docVIP

O-arm三维计算机导航系统引导下置钉修复严重脊柱畸形的安全性 王 涛，王 辉，宋艳丽，杨大龙，魏海醌，刘丰雨，丁文元(河北医科大学第三医院脊柱外科，河北省石家庄市 050051) 引用本文：王涛，王辉，宋艳丽，杨大龙，魏海醌，刘丰雨，丁文元. O-arm三维计算机导航系统引导下置钉修复严重脊柱畸形的安全性[J].中国组织工程研究，2016，20(26):3849-3855. DOI: 10.3969/j.issn.2095-4344.2016.26.008 ORCID: 0000-0001-5445-1091(王涛) 文章快速阅读： 文题释义： O-ARM导航系统：该导航成像系统的出现使得三维技术能够更好地应用于脊柱矫形术中，与传统的二维C型臂、三维C型臂和诊断CT相比，O-arm导航的特点和优势更加明显，能够提供每个手术部位的三维信息，并对手术过程实施全程跟踪，是肉眼和任何透视技术无法比拟的。 椎弓根螺钉置钉位置NEO分型0型椎弓根皮质4 mm有0枚(0%)。②手术时间(272.3±17.3) min，术中出血量(1 710.0±229.1) mL；③治疗前侧凸Cobb角为(70.5±6.0)°，治疗后侧凸Cobb角为(22.8±4.8)°；治疗前后凸Cobb角为(72.0±5.2)°，治疗后后凸Cobb角为(28.1±5.7)°，差异均有显著性意义(P 0.05)；④结果显示，在O-arm导航系统下修复严重脊柱畸形的置钉准确性高，降低了患者术中神经损伤的风险，侧凸、后凸畸形均得到了有效改善。 关键词： Safety of screw placement for severe spinal deformity with the use of O-arm three-dimensional computer-assisted navigation system Wang Tao, Wang Hui, Song Yan-li, Yang Da-long, Wei Hai-kun, Liu Feng-yu, Ding Wen-yuan (Department of Spine Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei Province, China) Abstract BACKGROUND: O-arm navigation integrates CT image quality and the flexible mobility of the C-arm. Surgery for severe spinal deformity is very difficult, with high incidence of nerve injury, so it is a challenging surgery for spinal surgery. The role of O-arm in the correction of spinal deformity is particularly important. OBJECTIVE: To explore the effect and safety of pedicle screw placement in severe spinal deformity under the guidance of O-arm navigation system. METHODS: Clinical data of 25 patients with severe spinal deformity with the aid of O-arm navigation were retrospectively analyzed. We observed pedicle screw insertion, operation time, intraoperative blood loss, correction of scoliosis and correction of kyphosis, and assessed the safety of screw insertion. RESULTS AND CONCLUSION: (1) Totally 326 pedicle screws were implanted in 25 patients. According to NEO classification, 280 pedicle screws (92%) belonged to grade 0 (no perforation of pedicle co