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首页> 外文期刊>Spine >Comparative results between conventional and computer-assisted pedicle screw installation in the thoracic, lumbar, and sacral spine.
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Comparative results between conventional and computer-assisted pedicle screw installation in the thoracic, lumbar, and sacral spine.

机译：在胸椎，腰椎和骨椎弓根螺钉与常规和计算机辅助椎弓根螺钉安装之间的比较结果。

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STUDY DESIGN: A comparative study on the position of pedicle screws in patients treated surgically with and without computer assistance. OBJECTIVES: To evaluate the accuracy of computer-assisted pedicle screw installation, and to evaluate its clinical benefit as compared with conventional pedicle screw installation techniques. SUMMARY OF BACKGROUND DATA: In vitro and clinical studies have documented a significant rate of misplaced screws in the thoracolumbar area. Neurologic complications are recognized problems caused by screw misplacement. METHODS: Patients treated surgically with computer assistance were compared with a historical control group of patients treated surgically with conventional techniques in the same hospital and by the same surgical team. All screw positions were measured with a postoperative magnetic resonance tomography, and cortical effractions were categorized in 2-mm increments. Patients' charts also were reviewed to assess individual neurologic outcomes. RESULTS: The control cohort was composed of 100 patients, with 544 screws from T5 to S1. The computer-assisted cohort was composed of 50 patients, with 294 screws from T2 to S1. In the control cohort, 461 of 544 screws (85%) were found completely within their pedicles as compared with 278 of 294 screws (95%) correctly placed in the computer-assisted group (P < 0.0001). All 16 screws incorrectly placed with computer assistance were found 0.1 mm to 2 mm from the pedicle cortex. In the control cohort, 68 screws were found 0.1 mm to 2 mm, 10 screws 2.1 mm to 4 mm, and 5 screws more than 4 mm from the pedicle cortex. Seven patients in the control cohort were surgically retreated because of postoperative neurologic deficits, whereas no patients in the computer-assisted group were surgically retreated. CONCLUSIONS: Computer assistance can decrease the incidence of incorrectly positioned pedicle screws.
机译：研究设计：一项有无计算机辅助手术治疗的患者椎弓根螺钉位置的比较研究。目的：评估计算机辅助椎弓根螺钉安装的准确性，并评估其与传统椎弓根螺钉安装技术相比的临床益处。背景数据摘要：体外和临床研究表明，胸腰椎区域的螺钉错位率很高。神经系统并发症是由螺钉错位引起的公认问题。方法：将在同一医院和同一外科团队中，采用计算机辅助手术治疗的患者与使用传统技术进行手术治疗的历史对照组进行比较。术后磁共振断层扫描测量所有螺钉的位置，并以2 mm的增量对皮质纤维化进行分类。还检查了患者的病历表以评估个体神经系统的预后。结果：该对照队列由100例患者组成，其中544颗螺钉从T5到S1。计算机辅助队列由50名患者组成，从T2到S1用294颗螺钉固定。在对照组中，发现完全位于椎弓根内的有544枚螺钉中的461枚（占85％），而正确放置于计算机辅助组的294枚螺钉中有278枚（占95％）（P <0.0001）。发现所有16颗螺钉在计算机辅助下均未正确放置，距椎弓根皮质0.1毫米至2毫米。在对照队列中，发现有68颗螺钉位于0.1毫米至2毫米之间，有10颗螺钉在2.1毫米至4毫米之间，还有5颗螺钉距椎弓根皮层超过4毫米。对照组中有7名患者因术后神经功能缺损而接受了手术治疗，而计算机辅助组中没有患者接受了手术治疗。结论：计算机辅助可以减少椎弓根螺钉放置不正确的可能性。

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