Abstract:

BACKGROUND: The achievement ratio of thoracic pedicle screw placement is not ideal, because of the complex environment surround vertebrae. With the sophisticated image equipment development, preoperative orthopedics examination becomes clearer and accurate.
OBJECTIVE: To compare the success rate and accuracy of thoracic pedicle screw placement achieved by screw insertion assisted by spiral CT image three dimensional reconstruction technique and the conventional free hand placement technique.
METHODS: A total of 56 patients with thoracic vertebrae injury were included. According to patients’ will to select placement means before internal fixation, three-dimensional reconstruction-aided group and conventional free hand technique group of 28 cases, respectively. All patients in three-dimensional reconstruction-aided group were treated with thoracic vertebrae scanning by high-resolution spiral CT, the data entered into computer database. According to software-generated three-dimensional images, surgical path and pedicle screw parameters were stimulated. Patients in conventional free hand technique group underwent ordinary X-ray and CT detection, reconstruction and stimulation function in three-dimensional reconstruction-aided group were not applied. The success rate of pedicle screws in all cases was recorded. The accuracy of pedicle screws was evaluated again by spiral CT scanning after internal fixation. 
RESULTS AND CONCLUSION: Compared with conventional free hand technique group, the success rate of thoracic screw placement in three-dimensional reconstruction-aided group was significantly increased (P < 0.05), the pedicle perforation rate was significantly reduced (P < 0.05). It is indicated that thoracic pedicle screw internal fixation with spiral CT three-dimensional reconstruction-aided technology can significantly improve the success rate and accuracy of thoracic screw placement.