导板导航在复杂腰椎椎弓根螺钉置入手术中的初步应用.pdfVIP

中华临床医师杂志(电子版)2013 年 12 月第 7 卷第 24期 Chin J Clinicians(Electronic Edition),December 15,2013,Vol.7,No.24 ·11574· ·新技术·新方法· 导板导航在复杂腰椎椎弓根螺钉置入 手术中的初步应用 张强 赵昌松 袁征 蔡娟 李鑫 【摘要】 目的 探讨导航导板椎弓根螺钉置入技术在复杂腰椎疾病手术中的应用价值。方法 回顾性 研究本组 7 例患者：严重退行性腰椎脊柱侧弯 4 例，退变性腰椎术后翻修 3 例，其中 HIV 阳性患者 2 例。 应用三维 CT断层扫描腰椎，保存数据为 DICOM格式输入计算机处理，然后进行病变区域的数字化三维重 建和快速成型，根据快速成型脊柱模型制作椎弓根导航导板，并将其应用于临床。同时随机抽取未做脊柱 模型的 7例严重腰椎患者作对照研究。结果 7例患者按计划成功完成了手术，无脊髓、神经、血管损伤手 术并发症，术后效果满意，术中所见与术前数字化三维重建模型的形状和测量结果完全一致，椎弓根导航 导板效果良好，术后 X 线和 CT 复查显示椎弓根螺钉位置正确。结论 快速成型脊柱模型椎弓根导板导航 是一种新的技术方法，技术简单，不需要特殊的手术经验，并且可以缩短手术时间，减少术中出血，减少 或避免手术中透视，为严重腰椎疾病手术中准确、安全有效的辅助技术手段。 【关键词】 腰椎； 椎弓根螺钉； 快速成型； 导板； 导航 Application of the pedicle drill template navigation technology in the operation of complicated lumbar spine disease ZHANG Qiang, ZHAO Chang-song, YUAN Zheng, CAI Juan, LI Xin.Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China Corresponding author: ZHANG Qiang, Email: zhangqwte@ 【Abstract】 Objective To investigate the valuation of the pedicle drill template navigation technology in the operation of complicated lumbar spine disease. Methods A retrospective analysis was performed in seven patients include: 4 cases of the degenerative complicated lumbar spinal scoliosis, 3 cases revision surgery after lumbar spine operation. 2 cases with HIV positive. A three-dimensional CT scan of their lumbar spine was performed, and the data were transferred via a DICOM network to a computer workstation. Three dimensional reconstruction and rapid prototype were achieved. The navigation drill template was manufactured by rapid prototyping for clinical operation using. 7 cases of complicated lumbar spine disease cases were selective randomly as control group. Results Seven patients were successfully operated as surgical planning without any complication, such as complication of spinal cord, nerve or blood vessel injury, and which had shown excellent post-operative outcomes. The o