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首页> 外文期刊>Neurocirugia >Fiabilidad del navegador en la colocación de tornillos pediculares toracolumbares
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Fiabilidad del navegador en la colocación de tornillos pediculares toracolumbares

机译：导航器在胸腰椎椎弓根螺钉放置中的可靠性

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Introduction. Computer image guidance is one of the most significant technologic advancements in the spine surgery, because preoperative or intraoperative images can be used for multiplanar, three-dimensional intraoperative navigation. Material and methods. We performed a prospective clinical study to assess the accuracy of pedicle screw insertion using an optoelectronic navigation system (SurgiGATE Spine 2.1 Medivision). The study population included 29 patients with diverse disorders of the thoraco- lumbar spine (degenerative 54%, spondylolisthesis 21%, fractures 14%, scoliosis 7% and spondylodiscitis 4%). One patient was excluded from the study because problems with the specific instruments or the computer system. Pre and post-operative axial computed tomography images were obtained for each patient and analyzed by two independent radiologists to placement accuracy. The correct location was defined accord to Heary scale in 5 grades. Results. 163 image-guided thoraco-lumbar pedicle screws were placed 29 in the thoracolumbar spine and 134 in the lumbosacral spine. We achieved a completely intraosseous placement (Grade I) in 99.4% of lumbosacral spine screws and 100% of thoracolumbar spine screws. Only one misplaced screw (Grade III) in the pedicle of L III in the concavity of a scoliosis was reported. No implant related complications were noted. Conclusions. The low rate of misplaced screws in this prospective study compares favorably with previously published results. Our initial results indicate that Image-guided spinal surgery is a safe technique which improves surgical performance during posterior transpedicle stabilization.
机译：介绍。计算机图像导航是脊柱外科手术中最重要的技术进步之一，因为术前或术中图像可用于多平面，三维术中导航。材料与方法。我们进行了一项前瞻性临床研究，以使用光电导航系统（SurgiGATE Spine 2.1 Medivision）评估椎弓根螺钉插入的准确性。研究人群包括29例胸腰椎疾患（变性54％，腰椎滑脱21％，骨折14％，脊柱侧弯7％和脊椎盘炎4％）。一名患者因为特定仪器或计算机系统出现问题而被排除在研究之外。获得了每位患者的术前和术后轴向计算机断层扫描图像，并由两名独立的放射科医生进行了分析，以确保准确定位。根据Heary等级在5个等级中定义了正确的位置。结果。将163根经图像引导的胸腰椎椎弓根螺钉放置在胸腰椎29处，腰ac椎134处。我们在99.4％的腰s部脊柱螺钉和100％的胸腰部脊柱螺钉中完成了完全骨内植入（I级）。据报道，在脊柱侧凸的凹腔中，L III椎弓根中只有一个放错位置的螺钉（III级）。没有发现与植入物相关的并发症。结论。在这项前瞻性研究中，螺钉错位率低，与以前发表的结果相吻合。我们的初步结果表明，影像引导脊柱外科手术是一种安全的技术，可在后椎弓根稳定术期间提高手术性能。

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