| 摘要: |
| ［摘要］ 目的 探讨数字化术前规划在腰椎重度退变椎弓根螺钉置入手术中的应用效果。方法 选择2018年5月至2020年5月在武汉中西医结合骨科医院接受腰椎椎弓根螺钉置入手术的患者47例，其中腰椎管狭窄症24例，退行性腰椎滑脱症23例。根据患者是否采用数字化术前规划将其分为观察组（采用数字化术前规划，22例）和对照组（未采用数字化术前规划，25例），均行经椎间孔入路椎间植骨融合术（TLIF）。比较两组置钉时间、置钉出血量、术中透视时间以及置钉精确度。结果 两组患者手术均顺利完成，术后均未发生神经损伤、脑脊液漏及切口感染等并发症。观察组22例共置钉152枚，对照组25例共置钉172枚。观察组单枚置钉时间、术中透视时间均短于对照组，单枚置钉出血量少于对照组，差异有统计学意义（P<0.05）。观察组总体置钉精确度显著优于对照组（P<0.05）。结论 对于腰椎关节重度退变患者，数字化术前规划可为置钉提供参考，有助于缩短置钉时间，减少术中出血量和透视时间，提高置钉精准度。 |
| 关键词: 腰椎 关节突重度退变 三维重建 椎弓根螺钉 术前规划 |
| DOI：10.3969/j.issn.1674-3806.2023.01.12 |
| 分类号:R 681.5 |
| 基金项目:武汉中西医结合骨科医院院内课题（编号：HGY202202） |
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| A study on the application effect of digital preoperative planning on the placement of pedicle screws in patients with severe lumbar vertebra degeneration |
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WANG Xiao-zhen, ZHANG Xiao-tong, WU Zhe-dong, et al.
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Department of Spine Surgery, Wuhan Orthopaedics Hospital of Integrated Traditional Chinese and Western Medicine(the Affiliated Hospital of Wuhan Sports University), Hubei 430079, China
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| Abstract: |
| ［Abstract］ Objective To study the application effect of digital preoperative planning on the placement of pedicle screws in patients with severe lumbar vertebra degeneration. Methods Forty-seven patients who received lumbar pedicle screw placement in Wuhan Orthopaedics Hospital of Integrated Traditional Chinese and Western Medicine from May 2018 to May 2020 were selected, including 24 patients with lumbar spinal stenosis and 23 patients with degenerative lumbar spondylolisthesis. The patients were divided into the observation group(with digital preoperative planning, 22 cases) and the control group(without digital preoperative planning, 25 cases) according to whether they received digital preoperative planning. The patients in both groups received transforaminal lumbar interbody fusion(TLIF). The time of the placement of pedicle screws, the blood loss during the time of the placement of pedicle screws, the time of intraoperative fluoroscopy and the accuracy of the placement of pedicle screws were compared between the two groups. Results The operation was successfully completed in the patients of the two groups, and there were no postoperative complications such as nerve injury, cerebrospinal fluid leakage and incision infection. A total of 152 nails were placed in 22 patients in the observation group and 172 nails were placed in 25 patients in the control group. The time of per nail placement and the time of intraoperative fluoroscopy in the observation group was shorter than that in the control group, and the blood loss during the time of per nail placement was less than that in the control group, with statistically significant differences between the two groups(P<0.05). The overall accuracy of nail placement in the observation group was significantly better than that in the control group(P<0.05). Conclusion For patients with severe lumbar joint degeneration, digital preoperative planning can provide reference for nail placement, which is helpful to shorten intraoperative time of nail placement, reduce intraoperative blood loss and fluoroscopy time, and improve the accuracy of nail placement. |
| Key words: Lumbar vertebra Severe facet joint degeneration Three-dimensional reconstruction Pedicle screw Preoperative planning |
