EVALUATION OF TWO-DIMENSION COMPUTER-AIDED SURGERY NAVIGATION SYSTEM FOR LUMBAR PEDICLE SCREW FIXATION ON RECOMBINANT CT SECTION AFTER OPERATION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WUChao ,  TANLun , LINXu , HUHaigang

Department of Orthopedics, the Fourth People's Hospital of Zigong City, Zigong Sichuan, 643000, P. R. China;

Corresponding?author：

TANLun, Email: flightiness@163.com

Keywords：

Computer-aided surgery navigation system; Lumbar vertebrae; Internal fixators

DOI：

10.7507/1002-1892.20150098

Video：

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Objective To investigate the accuracy of the two-dimension computer-aided surgery navigation system in the lumbar pedicle screw fixation on recombinant CT section after operation. Methods Between February 2011 and April 2013, 218 patients undergoing lumbar spinal pedicle screw fixation were divided into 2 groups:two-dimension computer-aided surgery navigation system was used in 95 cases (the navigation group) and X-ray fluoroscopy assistant technology in 123 cases (the fluoroscopy assistant group). There was no significant difference in age, gender, and type of disease between 2 groups (P>0.05). The mean operating time, blood loss volume, and fluoroscopy times, and the one-time success rate of pedicle screw implant were observed. The sagittal screw angle (SSA), the relationship between the pedicle cortex and screw, the accuracy rate of pedicle screw, and the sagittal angle on both sides (SBA) were observed. Results A total of 504 screws were inserted in navigation group, 432 (85.7%) were inserted successfully at first time and 472 (85.7%) were inserted successfully at end time. A total of 656 screws were inserted in fluoroscopy assistant group, 474 (72.3%) were successfully inserted at first time, and 563 (85.8%) were inserted successfully at end time. There were significant differences in the one-time success rate and final success rate of pedicle screw implant between 2 groups (χ²=30.19, P=0.00; χ²=18.16, P=0.00). There was no significant difference in the mean operating time and the blood loss volume of pedicle screw implant between 2 groups (t=0.88, P=0.38; t=1.47, P=0.14); but the fluoroscopy times of pedicle screw implant in navigation group 0.7±0.3 were significantly less than that in fluoroscopy assistant group 1.5±1.0 (t=-8.09, P=0.00). The SSA and SBA in navigation group[(3.7±0.9)° and (1.7±0.8)°] were significantly less than those in fluoroscopy assistant group[(6.0±1.7)° and (3.5±1.6)°] (t=-26.92, P=0.00; t=-22.49, P=0.00). Conclusion The sagittal screw angle and accuracy of pedicle screw implant can be significantly improved using the two-dimension computer-aided surgery navigation system in lumbar posterior fixation.

Citation： WUChao, TANLun, LINXu, HUHaigang. EVALUATION OF TWO-DIMENSION COMPUTER-AIDED SURGERY NAVIGATION SYSTEM FOR LUMBAR PEDICLE SCREW FIXATION ON RECOMBINANT CT SECTION AFTER OPERATION. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(4): 452-456. doi: 10.7507/1002-1892.20150098 Copy

1.	張超, 孫天威, 田融, 等. 兩種手術方式治療峽部裂型腰椎滑脫癥的對比研究. 中國修復重建外科雜志, 2015, 29(2):179-183.
2.	李鵬飛, 賈楠, 靳憲輝, 等. 椎間植骨粒體積對腰椎后路滑脫復位植骨融合內固定術后融合效果的影響. 中國修復重建外科雜志, 2013, 27(6):696-702.
3.	龔全, 孔清泉, 李濤, 等. 后路復位技術在重度腰椎滑脫癥治療中的應用. 中國修復重建外科雜志, 2013, 27(4):393-398.
4.	高明暄, 李旭升, 甄平, 等. 膨脹螺釘及釘道強化在骨質疏松椎體中的力學可靠性研究. 中華創傷骨科雜志, 2014, 16(6):521-526.
5.	Laine T, Lund T, Ylikoski M, et al. Accuracy of pedicle screw insertion with and without computer assistance:a randomized controlled clinical study in 100 consecutive patients. Eur Spine J, 2000, 9(3):235-240.
6.	劉延青, 劉巖, 張克, 等. 導航輔助腰椎椎弓根螺釘置入的誤差分析. 中國脊柱脊髓雜志, 2005, 15(12):736-739.
7.	宋永興, 曾忠友. 胸腰椎椎弓根螺釘置釘技術關鍵及其并發癥的預防. 中國矯形外科雜志, 2012, 20(14):1306-1308.
8.	殷海東, 黃明光, 黃東生, 等. 個體化選擇脊柱側凸患者胸椎椎弓根螺釘進釘點的研究. 中國脊柱脊髓雜志, 2009, 19(3):193-197.
9.	Steinmann JC, Herkowitz HN, el-Kommons H, et a1. Spinal pedicle fixation. Confirmation of all image-based technique for screw placement. Spine (Phila Pa 1976), 1993, 18(13):1856-1861.
10.	孫麟, 宋躍明, 龔全, 等. 實時三維導航技術應用于先天性脊柱側凸矯形的近期療效. 中國修復重建外科雜志, 2013, 27(2):129-134.
11.	Foley KT, Simon DA, Rampersaud YR. Virtual fluoroscopy:computer-assisted fluoroscopic navigation. Spine (Phila Pa 1976), 2001, 26(4):347-351.
12.	王黎明, 喻忠, 桂鑒超, 等. 計算機導航輔助下經皮椎體成形術. 中華骨科雜志, 2006, 10(26):676-681.
13.	譚倫, 吳超, 羅曉中, 等. 以椎板邊緣對腰椎椎弓根螺釘進釘點的個體化定位. 中國矯形外科雜志, 2008, 16(3):207-210.
14.	馮海龍, 陳隆益, 譚海斌, 等. 計算機導航輔助椎弓根螺釘固定的臨床研究. 中華神經外科雜志, 2007, 23(5):332-335.
15.	田偉, 劉亞軍, 劉波, 等. 計算機導航在脊柱外科手術應用實驗和臨床研究. 中華骨科雜志, 2006, 26(10):671-675.
16.	Richter M, Mattes T, Cakir B. Computer-assisted posterior instrumentation of the cervical and cervico-thoracic spine. Eur Spine J, 2004, 13(1):50-59.
17.	張良, 徐宏兵, 王英民, 等. 二維計算機輔助手術導航對雙側腰椎椎弓根螺釘植入一致性的影響. 中華骨科雜志, 2013, 33(12):1190-1195.
18.	Weinstein JN, Rydevik BL, Orausching WR, et al. Anatomical and technical considerations of pediele screw fixation. Clin Orthop Relat Res, 1992, (284):34-36.
19.	楊曦, 孔清泉, 宋躍明, 等. 計算機導航輔助椎弓根螺釘后路固定在骨質疏松患者中的臨床應用. 中國修復重建外科雜志, 2012, 26(2):196-200.
20.	吳超, 譚倫, 林旭, 等. 矢狀曲度參考模棒在胸腰椎骨折手術中的臨床應用. 中國脊柱脊髓雜志, 2013, 23(10):898-904.

1. 張超, 孫天威, 田融, 等. 兩種手術方式治療峽部裂型腰椎滑脫癥的對比研究. 中國修復重建外科雜志, 2015, 29(2):179-183.
2. 李鵬飛, 賈楠, 靳憲輝, 等. 椎間植骨粒體積對腰椎后路滑脫復位植骨融合內固定術后融合效果的影響. 中國修復重建外科雜志, 2013, 27(6):696-702.
3. 龔全, 孔清泉, 李濤, 等. 后路復位技術在重度腰椎滑脫癥治療中的應用. 中國修復重建外科雜志, 2013, 27(4):393-398.
4. 高明暄, 李旭升, 甄平, 等. 膨脹螺釘及釘道強化在骨質疏松椎體中的力學可靠性研究. 中華創傷骨科雜志, 2014, 16(6):521-526.
5. Laine T, Lund T, Ylikoski M, et al. Accuracy of pedicle screw insertion with and without computer assistance:a randomized controlled clinical study in 100 consecutive patients. Eur Spine J, 2000, 9(3):235-240.
6. 劉延青, 劉巖, 張克, 等. 導航輔助腰椎椎弓根螺釘置入的誤差分析. 中國脊柱脊髓雜志, 2005, 15(12):736-739.
7. 宋永興, 曾忠友. 胸腰椎椎弓根螺釘置釘技術關鍵及其并發癥的預防. 中國矯形外科雜志, 2012, 20(14):1306-1308.
8. 殷海東, 黃明光, 黃東生, 等. 個體化選擇脊柱側凸患者胸椎椎弓根螺釘進釘點的研究. 中國脊柱脊髓雜志, 2009, 19(3):193-197.
9. Steinmann JC, Herkowitz HN, el-Kommons H, et a1. Spinal pedicle fixation. Confirmation of all image-based technique for screw placement. Spine (Phila Pa 1976), 1993, 18(13):1856-1861.
10. 孫麟, 宋躍明, 龔全, 等. 實時三維導航技術應用于先天性脊柱側凸矯形的近期療效. 中國修復重建外科雜志, 2013, 27(2):129-134.
11. Foley KT, Simon DA, Rampersaud YR. Virtual fluoroscopy:computer-assisted fluoroscopic navigation. Spine (Phila Pa 1976), 2001, 26(4):347-351.
12. 王黎明, 喻忠, 桂鑒超, 等. 計算機導航輔助下經皮椎體成形術. 中華骨科雜志, 2006, 10(26):676-681.
13. 譚倫, 吳超, 羅曉中, 等. 以椎板邊緣對腰椎椎弓根螺釘進釘點的個體化定位. 中國矯形外科雜志, 2008, 16(3):207-210.
14. 馮海龍, 陳隆益, 譚海斌, 等. 計算機導航輔助椎弓根螺釘固定的臨床研究. 中華神經外科雜志, 2007, 23(5):332-335.
15. 田偉, 劉亞軍, 劉波, 等. 計算機導航在脊柱外科手術應用實驗和臨床研究. 中華骨科雜志, 2006, 26(10):671-675.
16. Richter M, Mattes T, Cakir B. Computer-assisted posterior instrumentation of the cervical and cervico-thoracic spine. Eur Spine J, 2004, 13(1):50-59.
17. 張良, 徐宏兵, 王英民, 等. 二維計算機輔助手術導航對雙側腰椎椎弓根螺釘植入一致性的影響. 中華骨科雜志, 2013, 33(12):1190-1195.
18. Weinstein JN, Rydevik BL, Orausching WR, et al. Anatomical and technical considerations of pediele screw fixation. Clin Orthop Relat Res, 1992, (284):34-36.
19. 楊曦, 孔清泉, 宋躍明, 等. 計算機導航輔助椎弓根螺釘后路固定在骨質疏松患者中的臨床應用. 中國修復重建外科雜志, 2012, 26(2):196-200.
20. 吳超, 譚倫, 林旭, 等. 矢狀曲度參考模棒在胸腰椎骨折手術中的臨床應用. 中國脊柱脊髓雜志, 2013, 23(10):898-904.

Chinese Journal of Reparative and Reconstructive Surgery

EVALUATION OF TWO-DIMENSION COMPUTER-AIDED SURGERY NAVIGATION SYSTEM FOR LUMBAR PEDICLE SCREW FIXATION ON RECOMBINANT CT SECTION AFTER OPERATION

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