Accuracy of digital orthopedic three-dimensional reconstruction for thoracolumbar pedicle screw placement

doi:10.3969/j.issn.2095-4344.2017.03.009

Abstract

Abstract:

BACKGROUND: With the emergence of more sophisticated imaging instruments in recent years, orthopedic preoperative examination becomes more clear and accurate. With the help of three-dimensional reconstruction technology, it is bound to improve the accuracy of pedicle screw placement.

OBJECTIVE: To investigate the accuracy and safety of digital three-dimensional reconstruction technique in the placement of thoracolumbar pedicle screw.

METHODS: 200 cases of pedicle screw fixation were collected and randomly divided into two groups. One group was treated with traditional anatomical landmarks combined with intraoperative fluoroscopic fixation of pedicle screws. Assisted thoracic pedicle screws were implanted with digital three-dimensional reconstruction technique. Preparation time, the amount of bleeding, accuracy of pedicle screw placement, and neurovascular injury of pedicle were recorded by comparing the preoperative and postoperative spine digital models of the pre-and post-virtual spine.

RESULTS AND CONCLUSION: (1) The accuracy rate of pedicle screw placement was 85% and 99% in the nail-hand nail group and the auxiliary nail group respectively, and the success rate of one-time placement was 80% and 95%; the excellent and good rates of placement were 86% and 96%, respectively (P > 0.05). (2) The preparation time of nail channel was (5.87±1.34) minutes and the volume of blood loss during nailing was (10.08±7.58) mL in the nail-hand nailing group. The preparation time of nail channel was (3.91±2.28) minutes and the volume of blood loss during nailing was (18.31±8.56) mL in the auxiliary nail group. There was significant difference between the two groups (P < 0.05). (3) Nerve injury occurred in six cases, and vascular injury in eight cases in the nail-hand nailing group. Nerve injury occurred in 0 case, and vascular injury in one case in the auxiliary nail group. There were significant differences in nerve and vascular injuries between the two groups (P < 0.05). (4) These results confirm that the accuracy and safety of digital three-dimensional reconstruction technique in the treatment of thoracolumbar pedicle screw placement are high.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Imaging, Three-Dimensional, Thoracic Vertebrae, Lumbar Vertebrae, Internal Fixators, Tissue Engineering

CLC Number:

R318

Chen Lu-yao, Hu Shi-qiang, Wang Xiao-ping, Wu Wei-wei, Wei Zhan-tu, Huang Jian. Accuracy of digital orthopedic three-dimensional reconstruction for thoracolumbar pedicle screw placement [J]. Chinese Journal of Tissue Engineering Research, 2017, 21(3): 373-377.

Figures/Tables 1

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