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- Title
脊柱侧弯复杂椎弓根情况下 5 点定位法点状接触式椎弓根导航模板的应用.
- Authors
王力航; 陆廷盛; 陈啟鸰; 姚书眈; 蒲兴魏; 姬林松; 赵国权; 欧阳北平; 张 斌; 杨再松; 罗春山
- Abstract
BACKGROUND: The pedicle navigation template has many advantages, but there are still some problems. For example, poor soft tissue dissection leads to poor adhesion of the pedicle navigation template, resulting in screw path deviation; careful dissection of soft tissue to fit the pedicle navigation template leads to prolonged surgery time and increased bleeding; the design of the pedicle navigation template cannot predict the vertebral rotation and the impact of body position changes, resulting in the poor fitting. OBJECTIVE: To explore the utility of a new 5-point positioning point-contact pedicle navigation template in the case of scoliosis and complex pedicle. METHODS: A total of 20 patients with scoliosis and complicated pedicle admitted to the Department of Spinal Surgery, Guizhou Hospital, Beijing Jishuitan Hospital from February 2020 to February 2023 were selected for scoliosis orthopedics. During the operation, the 5-point positioning point-contact pedicle navigation template was used to guide the screws. According to the inclusion and exclusion criteria, 34 cases were matched as the empirical nail placement group, and conventional barehanded nail placement was performed. The time of placement, the amount of bleeding, the number of fluoroscopies, the number of manual diversions, the level and accuracy of pedicle screws, the complications of placement, and the rate of correction of main curvature were compared between the two groups. RESULTS AND CONCLUSION: (1) There were no significant differences in sex, age, coronal Cobb’s angle of the main curvature, bending Cobb’s angle of the main curvature, pedicle variation, apex rotation, fusion segment, number of screws, level of screws, accuracy of screws, and rate of correction of main curvature between the navigation template group and the empirical nail placement group (P > 0.05). (2) Compared with the empirical nail placement group, the navigation template group had more advantages in time of placement (P=0.034), amount of bleeding (P=0.036), number of fluoroscopies (P=0.000) and number of manual diversions (P=0.021). (3) There were 0 cases of screw-related complications in both groups. (4) In conclusion, the 5-point positioning pointcontact 3D printing pedicle navigation template has a claw-like structure. It can firmly adapt to various deformities of the lamina articular process, avoid drift, and accurately place the screws. It has a point-like contact lamina structure to avoid extensive and complete dissection of the posterior structure, and reduce bleeding, operation time, and trauma. Pre-designed screw entry points and directions can reduce the number of fluoroscopy and operation time. Segmental design can avoid discomfort due to changes in anesthesia position. The operation is simple and the accuracy of screw placement is high.
- Subjects
GUIZHOU Sheng (China); POSTURE; THREE-dimensional printing; SPINAL surgery; SCREWS; SCOLIOSIS
- Publication
Chinese Journal of Tissue Engineering Research / Zhongguo Zuzhi Gongcheng Yanjiu, 2024, Vol 28, Issue 18, p2859
- ISSN
2095-4344
- Publication type
Article
- DOI
10.12307/2024.037