[DOC]红外线透视导航在胸腰椎椎弓根螺钉固定术中的应用.docVIP

[DOC] 红外线透视导航在胸腰椎椎弓根螺钉固定术中的应用 红外线透视导航在胸腰椎椎弓根螺钉固定 术中的应用 ll96JournalofChinesePhysician,September,2006,Vol8,No9 红外线透视导航在胸腰椎椎弓根螺钉固定术中的应用 喻忠,王黎明,徐杰,桂鉴超,蒋纯志,王钢锐,郑圣鼐,姚京东,侯明夫 (江苏省南京医科大学附属南京第一医院脊柱外科中心,江苏南京210006) 【摘要】目的探讨红外线透视导航系统在胸腰椎椎弓根螺钉植入手术过程中的应用.方法32例患者在导航下椎弓根螺 钉固定术,其中19例为外伤后胸腰椎骨折,5例为腰椎间盘突出或腰椎管狭窄,8例为腰椎滑脱.记录术中螺钉的植入的时间,出 血量,术后进行CT扫描,按Andrew分类法评估螺钉的位置.结果导航下成功对32例患者共植入168枚椎弓根螺钉,其中T..10 枚,T.20枚,L.18枚,L236枚,L316枚,L426枚,L528枚,s.14枚.按Andrew分类法:I级,165枚(98%);II级,2枚;?级,1枚. 术后临床无神经症状.平均每钉从注册到植入手术时间为(10?2,4)min,出血量:胸腰椎骨折平均为(400?52,3)ml,腰椎间盘突 出或腰椎管狭窄(200?36.8)ml;腰椎滑脱(300?44,6)ml.结论红外线透视导航系统可以准确引导胸腰椎椎弓根螺钉的植入, 减少出血量,缩短手术时间. [关键词]红外线/诊断应用;骨折固定术,内;胸椎/外科学;腰椎/外科学 Applicationofinfraredfluoroscopicnavigationinguidingpediclescrewfixationofthoraic—lumbarspine YUZhong,WANGLi—ming,XUfie,GUIJian—chao,NGChun—zhi,WA rui,ZHENSheng—nai,YAOJing—dong,HOU NGGang— Ming-fu.DepartmentofOrthopedicSurgery,theNanjingFirstHospitalAffiliatedtoNanjingMedicalUniversty,Nanjing210006,China 【Abstact】 ObjectiveToevaluatetheapplicationofinfraredfluoroscopicnavigationguidingpediclescrewfixationofthoracic—lumbar spine,MethodsThepediclescrewfixationofthoraic—lumbarspinewasadop tedin32patients,including19caseswiththoracic—lumbar spinefractures,5caseswithprotrusionoflumbarintervertebraldiscorvertebralcanalstenosis,8caseswithlumbarspineslippage,Thetime forpediclescrewfixationandamountofbleedingwererecorded.Thepediclescrewpositionwasassessedwithpost—operativeCTbyusingAn— drewgrade,ResultsTotally148screwswerefixedin32casessuccessfully,including10screwsinTll,20inTl2,18inLl,36inL2,16in ,26inL4,28inL5,and14inSl,Accordingtoandrewgrade,165screwswereinIgrade(98%),2inIIgrade,and1inIIIgrade,No nerveandspinalcorddamageWasobservedafteroperation,TheaveragetimeofperpedicleSCreWfixationwas(10?2.4)min,Theaverage amountofbleedingWas(400?52.3)mlinthoracic—LumbarSpinefractures, (200?36.8)mlinprotrusionoflumbarintervertebraldiscor vertebralcanalstenosis,and(300?44.6)mlinLumbarSpineslippage.Conclu sionInfraredfluoroscopicn