数字化辅助与传统技术椎体成形术的比较
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开平市中心医院

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数字化模型辅助椎弓根精准穿刺关键技术研究及临床应用


Comparison of digital assistance with traditional techniques in vertebroplasty
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The Central Hospital of Kai Ping

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Study on the key technology of accurate pedicle puncture assisted by digital model

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    摘要:

    摘要:[目的] 探讨数字化技术辅助经皮椎弓根穿刺在胸腰椎骨折治疗中的精准性及可行性。[方法] 采用前瞻性对照病例分析,对我院2019年1月至2020年8月的73例单节段骨质疏松性椎体压缩性骨折行经皮椎体成形术的患者,根据随机数字法分成两组,传统组37例行传统经单侧椎弓根入路椎体成形术,数字组36例术前行三维数字化建模及数据测量,术中根据术前测量数据行经单侧椎弓根入路椎体成形术。比较两组手术时间、穿刺时间、X线透视次数、骨水泥的注入量及并发症发生率;不同时点(术前、术后3天及末次随访)椎体前缘高度、Cobb角、疼痛视觉模拟评分(visual analogue scale, VAS)、Oswestry 功能障碍指数(ODI)、JOA评分。[结果]手术时间数字组<传统组[(33.19±5.37)min vs. (45.81±8.46)min];穿刺时间数字组<传统组[(14.28±2.86)min vs. (24.81±6.89)min];X线透视次数数字组<传统组[(13.64±3.19)次 vs. (19.59±3.08)次] (P<0.05)。两组术后椎体前缘高度与Cobb角均较术前有所恢复(P<0.05),但组间比较无显著性差异(P>0.05)。两组术后VAS、ODI、JOA评分均较术前明显改善(P<0.05),术后3天VAS数字组<传统组[(3.52±0.94)分 vs. (4.19±0.81)分] (P<0.05),ODI数字组<传统组 [(34.56±4.06)% vs. (37.12±5.78)%] (P<0.05), JOA评分数字组>传统组[(25.31±1.24) 分vs. (24.54±1.35)分]。骨水泥注入量及渗漏率两组间无显著性差异(P>0.05)。[结论] 数字化技术辅助经皮椎弓根穿刺可提高胸腰椎经皮椎弓根穿刺的精准性,有助于减少X线透视次数及手术时间,且术后效果更好,可用于胸腰椎经皮椎弓根穿刺手术。

    Abstract:

    Abstract: [Objective] To investigate the accuracy and feasibility of digital technology assisted percutaneous pedicle puncture in the treatment of thoracolumbar fracture. [Methods] A prospective controlled case analysis was conducted to analyze 73 patients who underwent percutaneous vertebroplasty for single-segment osteoporotic vertebral compression fractures in our hospital from January 2019 to August 2020. The patients were divided into two groups by random number method: 37 patients in the traditional group underwent vertebroplasty via traditional unilateral pedicle approach,while the remaining 36 patients in the digital group were performed vertebroplasty via unilateral pedicle approach with the guide of preoperative 3D digital models and data measurement. The operative time, puncture time, intraoperative total fluoroscopy times, injection volume of bone cement and complication rate, anterior vertebral height, Cobb’s angle, visual analogue scale (VAS) , Oswestry disability index (ODI) and JOA scores at different period (preoperatively, 3 days and 6 months postoperatively) were compared between the two groups. [Results] The operative time showed that digital group 0.05). VAS, ODI scores and JOA scores in both groups were significantly improved postoperatively (P<0.05), The VAS score showed that didital group(3.52±0.94) was less than the conventional group (4.19±0.81) and the ODI showed that didital group(34.56±4.06)% was less than the conventional group (37.12±5.78)% while the JOA scores show that digital group(25.31±1.24) was higher than the counterpart(24.54±1.35) 3 days postoperatively(P<0.05). There was no significant difference in the amount of bone cement injection and the leakage rate between the two groups (P>0.05). [Conclusion] Digital technology assisted percutaneous pedicle puncture can improve the accuracy of thoracolumbar percutaneous pedicle puncture, which helps to reduce the times of fluoroscopy and operation time and has better postoperative effect, can be used for thoracolumbar percutaneous pedicle puncture surgery.

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  • 收稿日期:2021-09-01
  • 最后修改日期:2021-12-01
  • 录用日期:2022-02-25
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