脊椎定位框在胸腰椎手术术前定位中的临床应用
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摘要
目的探讨脊柱定位尺在胸腰椎后路手术术前定位中的应用价值。方法 2013年11月~2014年11月因胸腰椎疾病行后路手术治疗的患者93例,其中胸腰椎骨折42例,胸腰椎椎管内占位10例,腰椎间盘突出症及腰椎管狭窄症41例。患者均采用克氏针或脊椎定位框在C型臂X线机透视下进行定位。记录患者的年龄、疾病类型、定位时间、C臂透视次数、定位节段及定位准确率。结果脊椎定位框定位法组与克氏针定位法组的定位时间分别为1.63±0.93、3.00±1.49min,透视次数分别为1.25±0.49、1.68±0.73次,脊椎定位框定位法少于克氏针定位法(P<0.01);定位准确率分别为97.5%、94.3%,差异无统计学意义(P>0.05)。结论脊椎定位框联合C型臂X线机透视下进行胸腰椎手术术前定位在脊柱微创手术中,特别是多节段后路手术,具有推广应用的价值。
Objective To explore the value of spinal positioning frame using in thoracolumbar posterior operation. Methods From October 2013 to November 2014,93 patients with thoracolumbar disorders performed thoracolumbar posterior operation. There were 42 thoracolumbar vertebrae fractures,10 spinal canal occupant diseases,41 lumbar intervertebral disc herniation and lumbar spinal stenosis.Every patient was performed preoperative localization by Kirschner pointer or spinal positioning frame with C- arm fluoroscopy. The age,disorder,positioning time,fluoroscopy times,spine level and location accuracy were recorded. Results The positioning time was 1. 63 ±0. 93 min,3. 00 ± 1. 49 min,fluoroscopy time was 1. 25 ± 0. 49,1. 68 ± 0. 73 in spinal positioning frame group and Kirschner pointer group respectively( P < 0. 01). Location accuracy in spinal positioning frame was 97. 5% compared to 94. 3% in Kirschner pointer group. Conclusion Spinal positioning frame with C- arm fluoroscopy in preoperative localization for posterior thoracolumbar operation had application value in spine minimally invasive surgery.
Objective To explore the value of spinal positioning frame using in thoracolumbar posterior operation. Methods From October 2013 to November 2014,93 patients with thoracolumbar disorders performed thoracolumbar posterior operation. There were 42 thoracolumbar vertebrae fractures,10 spinal canal occupant diseases,41 lumbar intervertebral disc herniation and lumbar spinal stenosis.Every patient was performed preoperative localization by Kirschner pointer or spinal positioning frame with C- arm fluoroscopy. The age,disorder,positioning time,fluoroscopy times,spine level and location accuracy were recorded. Results The positioning time was 1. 63 ±0. 93 min,3. 00 ± 1. 49 min,fluoroscopy time was 1. 25 ± 0. 49,1. 68 ± 0. 73 in spinal positioning frame group and Kirschner pointer group respectively( P < 0. 01). Location accuracy in spinal positioning frame was 97. 5% compared to 94. 3% in Kirschner pointer group. Conclusion Spinal positioning frame with C- arm fluoroscopy in preoperative localization for posterior thoracolumbar operation had application value in spine minimally invasive surgery.
引文
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9 贺石生,张海龙,顾昕,等.腰椎微创手术术前定位器的设计及临床应用[J].中华骨科杂志,2011,31(10):1170-1171
2 龙浩,白波,卢永辉,等.经皮胸腰椎弓根置钉三维定位器的研制[J].中华生物医学工程杂志,2011,4(17):156-158
3 Rosahl SK,Gharabaghi A,Liebig T,et al.Skin markers for surgical planning for intradural lesions of the thoracic spine[J].Surg Neurol,2002,58(5):346-348
4 Paolini S,Ciappetta P,Mismri P,et al.Spinous process marking:a reliable method for preoperative surface localization of intradural lesions of the high thoracic spine[J].Br J Neurosurg,2005,19(1):74-76
5 许振生.腰段脊柱手术中椎体定位错误的原因分析[J].广州医药,1999,30(5):25-26
6 蔡俊丰,彭庄,祝建光,等.脊柱定位尺在胸腰椎后路手术术前定位中的应用[J].中国脊柱脊髓杂志,2010,20(4):317-321
7 谭清实,徐宝山,夏群,等.腰椎定位器在腰椎间盘镜手术中的应用[J].中华骨科杂志,2010,30(3):308-309
8 许海云,石荣坚,陆佳俊,等.椎弓根定位网在经皮球囊扩张椎体后凸成形术(PKP)术中椎弓根定位的应用[J].大家健康:学术版,2012,6(8):4-6
9 贺石生,张海龙,顾昕,等.腰椎微创手术术前定位器的设计及临床应用[J].中华骨科杂志,2011,31(10):1170-1171