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首页> 外文期刊>Neurocirugia >Fijación vertebral posterior guiada por neuronavegación: Experiencia en 121 casos
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Fijación vertebral posterior guiada por neuronavegación: Experiencia en 121 casos

机译：神经导航引导后椎固定术：121例经验

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Introduction. The authors present the results of a series of 121 cases of posterior vertebral fixation carried out from Sept 2008 to Sept 2010 using Flouro 2D-TC assisted Vector Vision o Kolibri navigator. (Brain LAB, Feldkirchen, Germany). Material. The sample included 68 males and 53 females. Age range was 24-75 with an average of 50.35., all with indication for instrumentation by different pathologies. Method. Patients presenting vertebral lesions of varying ethiology and lesion level with vertebral posterior fixation indication were included in the study. All underwent a CT before surgery, according to navigation protocol, and the images obtained were merged in the navigator with those obtained in the operating room with a Flouro 2D, which allowed a high quality 3D reconstruction to be performed and thus the capacity to navigate in a real-virtual manner. To evaluate the results of the implant a post-op CT was performed and the position of the implant was defined according to the Heary scale. The calabration time of the material was also evaluated, number of shots with the Flouro-2D, and for clinical evaluation VAS scales were employed, Oswestry and JOA (L), as well as the degree of satisfaction and acceptance of the procedure. Results. A total of 580 screws were implanted, distributed in 62 cervicals of which 24 were in C1-C2, 38 dorsals, 370 lumbar and 110 sacral. Open surgery was performed in 42 cases, MIS in 28 and percutaneous in 51. The presision of the implant was 98.45% with a global deviation of 1.55%, that according to the Heary scale was distributed in grade ll: 2 (1 cervical, 1 lumbar) grade lll: 4 (1 cervical, 2 dorsal, 1 lumbar), grade IV: 3 (1 cervical, 2 lumbar). General average time of calibration per procedure was 2 min. 49 seconds and the mean flouroscopic exposure was one shot at cervical and dorsal and two shots at lumbar level. The clinical evaluation at one month of 121 patients was 8.6/3.0 in the VAS, 68.0% / 23.0% in Oswestry and 6.4/13.1 in JOA (L), with those parameters remaining stable at 3 months in 100 and at 6 months in 87 patients respectively, and the degree of satisfaction between being completely and very satisfied with the procedure was 94.9%, and those who would submit to another treatment was more than 94%. Conclusion. Navigation with Flouro-2D-CT is a high precision technique that reduces complications of varying severity according to the level operated well as number of reinterventions, radiation exposure and surgical time.
机译：介绍。作者介绍了从2008年9月至2010年9月使用Flouro 2D-TC辅助Vector Vision o Kolibri导航仪进行的121例后路椎骨固定的结果。 （德国费尔德基兴的大脑实验室）。材料。样本包括68名男性和53名女性。年龄范围为24-75岁，平均为50.35。方法。该研究包括表现出不同病因和病变水平，椎体后路固定的椎体病变患者。根据导航协议，所有患者均在手术前进行了CT检查，并将所获得的图像在导航仪中与在手术室中使用Flouro 2D获得的图像进行了合并，从而可以执行高质量的3D重建，从而可以在其中进行导航一种真正的虚拟方式。为了评估植入物的结果，进行了术后CT检查，并根据Heary评分标准定义了植入物的位置。还评估了材料的校准时间，使用Flouro-2D拍摄的次数，并使用VAS量表，Oswestry和JOA（L）进行了临床评估，以及对该程序的满意程度和接受程度。结果。总共植入了580颗螺钉，分布在62个颈椎中，其中24个位于C1-C2、38个背侧，370个腰椎和110个骨中。开放手术42例，MIS 28例，经皮51例。植入物的准确率为98.45％，整体偏差为1.55％，根据Heary量表在ll级分配：2（1例宫颈，1例腰椎）III级：4（1例颈椎，2背侧，1个腰椎），IV级：3（1例颈椎，2个腰椎）每个步骤的校准平均总时间为2分钟。 49秒，平均透视在颈部和背侧拍摄1次，在腰部水平拍摄2次。 121例患者在1个月时的临床评估在VAS中为8.6 / 3.0，在Oswestry中为68.0％/ 23.0％，在JOA（L）中为6.4 / 13.1，这些参数在100个月的3个月和87个月的6个月保持稳定病人对手术的完全满意和非常满意之间的满意度为94.9％，愿意再次接受治疗的患者的满意度超过94％。结论。 Flouro-2D-CT导航是一种高精度技术，可根据手术水平，再干预次数，放射线暴露量和手术时间减少严重程度不同的并发症。

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